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1689840738
LAURA A JACKSON
FORT WORTH, TX
NPI
1689840738
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA05727)
Enumeration Date
2008-05-07
Last Update Date
2011-06-22
Business Address
-- LAURA A JACKSON PA
801 7TH AVE
FORT WORTH, TX 76104-2733
Phone number: 682-885-4054
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Mailing Address
-- LAURA A JACKSON PA
PO BOX 99371
FORT WORTH, TX 76199-0371
Phone number: 682-885-1855
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