Gary Wayne Jackson, PA

NPI #1154528263 in Levelland, Texas

Provider Information

NPI Number: 1154528263
Entity Type: Individual
Name: Gary Wayne Jackson, PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jul 2, 2007
Last Updated: Dec 1, 2008

Practice Location

Address: 1804 COLLEGE AVE
City: Levelland
State: Texas
ZIP Code: 79336-6507
Phone: (806) 894-3141

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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