DR. Grace Nightingale Cortez Jackson, M.D.

NPI #1104020775 in Austin, Texas

Provider Information

NPI Number: 1104020775
Entity Type: Individual
Name: DR. Grace Nightingale Cortez Jackson, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pathology - Anatomic Pathology & Clinical Pathology
Credential: M.D.
Enumeration Date: Jun 14, 2007
Last Updated: Oct 15, 2014

Practice Location

Address: 3445 EXECUTIVE CENTER DRIVE
Address 2: SUITE 250
City: Austin
State: Texas
ZIP Code: 78731-1678
Phone: (512) 579-4000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pathology - Anatomic Pathology — Anatomic Pathology	207ZP0101X
Pathology - Anatomic Pathology & Clinical Pathology — Anatomic Pathology & Clinical Pathology	207ZP0102X	Primary

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