Jennifer L Tackett, PA-C

NPI #1376587600 in Austin, Texas

Provider Information

NPI Number
1376587600
Entity Type
Individual
Name
Jennifer L Tackett, PA-C
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Credential
PA-C
Enumeration Date
Jun 16, 2006
Last Updated
Jan 9, 2024

Practice Location

Address
11675 JOLLYVILLE RD STE 207
City
Austin
State
Texas
ZIP Code
78759-4105
Phone
(512) 856-1000

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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