HOLLY JACKSON


Address: 4421 Highway 6 S Ste 100, College Station, TX 77845-6176
Phone: 9797315200

HOLLY JACKSON (NPI# 1467826248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467826248
Entity Type Individual
Full Name HOLLY JACKSON
Other Name HOLLY KOONCE
Credential PA-C
Practice Address 4421 Highway 6 S Ste 100
College Station
TX 77845-6176
Mailing Address 805 Hill Blvd Unit 104
Granbury
TX 76048-1482
Practice Telephone 9797315200
Practice Fax Number 9797315210
Mailing Telephone 8175735760
Enumeration Date 2015-11-17
Last Update Date 2018-11-28
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA10119 TX Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
805 Hill Blvd Unit 104, Granbury, TX 760481482 8175735760

Other Providers HOLLY JACKSON

NPI Name Taxonomy Address Enumeration
1689275802 Holly Marie Jackson Technician 448 W Cooper St, Tipton, MO 65081-8217 2020-11-04
1689156721 Holly Alegro Jackson Non-emergency Medical Transport (VAN) 10550 Murat Dr, Saint Louis, MO 63136-4524 2018-09-05
1417351453 Holly Jean Jackson Licensed Practical Nurse 5a Lafayette Avenue, Canandaigua, NY 14424 2014-10-20
1013212711 Holly Jackson Social Worker 511 W 86th Ter, Kansas City, MO 64114-2822 2011-01-11
1083882278 Holly Jackson Licensed Practical Nurse 2040 Murray Holladay Rd Ste 205, Salt Lake City, UT 84117-5197 2008-02-11
1548753700 Holly Jean Jackson Behavior Technician 19800 Village Office Ct, Bend, OR 97702-1872 2018-06-12
1922596220 Holly Suzanne Jackson Counselor 1100 Walnut St, Owensboro, KY 42301-2956 2018-04-23
1720575392 Holly Jackson Nurse Anesthetist, Certified Registered 7601 Southcrest Pkwy, Southaven, MS 38671-4739 2018-04-18
1427576511 Holly M Jackson Nurse Practitioner 905 Dixie St, Carrollton, GA 30117-4417 2017-09-08
1427597301 Holly Jackson Registered Nurse 1109 Jones St, Kennett, MO 63857-3824 2017-02-13

Office Location

Street Address 4421 HIGHWAY 6 S STE 100
City COLLEGE STATION
State TX
Zip Code 77845-6176

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104874809 Janet Krueger Emergency Medicine 4421 Highway 6 S Ste 100, College Station, TX 77845-6176 2006-05-04
1366930174 Kelli Rich Nurse Practitioner 4421 Highway 6 S Ste 100, College Station, TX 77845-6176 2018-04-26
1396126116 Jana Kimberlin Nurse Practitioner 4421 Highway 6 S Ste 100, College Station, TX 77845-6176 2015-06-17
1740445758 Mario Rizalino Bascon Roa Jr. Family Medicine 4421 Highway 6 S Ste 100, College Station, TX 77845-6176 2008-07-20
1982724134 Richard Lawrence Delezene Physician Assistant 4421 Highway 6 S Ste 100, College Station, TX 77845-6176 2007-03-30

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518503101 Aggieland Urgent Care Pllc Clinic/Center 13055 Fm 2154 Rd, College Station, TX 77845 2019-11-19
1770053399 Alyssa Nicole Sanchez Licensed Vocational Nurse 4030 Hwy 6 S 150, College Station, TX 77845 2018-11-27
1154805778 Medical Care Innovation, P.C. Clinic/Center 200 Quality Circle, College Station, TX 77845 2018-09-19
1003302530 Kaye Lynn Tseng Registered Nurse 4030 Hightway 6 South, College Station, TX 77845 2018-07-09
1083117907 College Station Dentistry and Orthodontics Pllc Dentist 11671 Fm 2154, Suite 400, College Station, TX 77845 2018-03-16
1912409954 H-e-b, Lp Clinical Medical Laboratory 11675 Fm 2154, College Station, TX 77845 2018-03-06
1871095745 Gregory Nicholas Perry Physical Therapist 4091 Sh 6 South, Suite B, College Station, TX 77845 2018-03-06
1811435639 Michael Patke Student in an Organized Health Care Education/Training Program 10613 Deer Run Dr., College Station, TX 77845 2017-02-01
1558810473 Sara Beth Williamson Nurse Practitioner 4401 State Hwy 6 S, College Station, TX 77845 2016-10-04
1881067379 Kieshia Lewis Occupational Therapy Assistant 2700 Earl Rudder Frwy Suite 1200, College Station, TX 77845 2015-11-05
Find all providers in zip 77845

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1174591242 Jon C Teacle Physician Assistant 2803 Earl Rudder Fwy S Ste 103, College Station, TX 77845-6099 2006-03-14
1396305306 Gerald Darling IIi Physician Assistant 2911 Texas Ave S Ste 103, College Station, TX 77845-5388 2019-06-20
1811491038 Brittney A Pohler Physician Assistant 800 Scott and White Dr, College Station, TX 77845-6440 2018-03-21
1982107504 Genevieve Lois Gourlay Physician Assistant 700 Scott and White Dr, College Station, TX 77845-6441 2018-03-09
1255790366 Porscha Buck Physician Assistant 800 Scott and White Dr, College Station, TX 77845-6440 2016-02-17
1427421270 Shannon Easterling Physician Assistant 800 Scott and White Dr, College Station, TX 77845-6440 2015-11-02
1316333149 Claudia Cantu Physician Assistant 1264 Tamu, College Station, TX 77843-0001 2015-04-08
1003204355 Brittany Rae Rhinehart Physician Assistant 700 Scott and White Dr, College Station, TX 77845-6441 2015-01-08
1841613817 Amanda Campbell Johnston Physician Assistant 700 Scott and White Dr, College Station, TX 77845-6441 2014-01-28
1174955751 Haley Allison Jeffrey Physician Assistant 1700 University Dr E, College Station, TX 77840-2661 2013-08-06
Find all providers in COLLEGE STATION

Competitor

Search similar providers

City COLLEGE STATION
Zip Code 77845

Improve Information

Please comment or provide details below to improve the information on HOLLY JACKSON.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches