DR. TAMMY LYNN JACKSON (NPI# 1619958758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619958758 |
| Entity Type | Individual |
| Full Name | DR. TAMMY LYNN JACKSON |
| Credential | PH.D. |
| Practice Address |
4201 Whispering Creek Dr College Station TX 77845-4054 |
| Practice Telephone | 9794739823 |
| Mailing Telephone | 9794739823 |
| Mailing Fax Number | 8667138251 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2019-10-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
31418 | TX | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
31418 | TX | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
31418 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 158249604 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7607 Eastmark Dr, Ste 253c, College Station, TX 778404030 | 9796902778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972767994 | Tammy Jackson | Behavioral Analyst | 556 New Park Ave Ste A, West Hartford, CT 06110-1317 | 2008-07-18 |
| 1467990671 | Tammy Jackson | Psychologist | 376 E Apple Ave, Muskegon, MI 49442-3466 | 2017-02-08 |
| 1538567573 | Tammy M Jackson | Licensed Practical Nurse | 2250 Wehrle Dr, Suite 1, Williamsville, NY 14221-7034 | 2014-12-08 |
| 1235294018 | Tammy J Jackson | Psychologist | 1272 Ne Windsor Dr, Lees Summit, MO 64086-5594 | 2006-12-22 |
| 1093736720 | Tammy S Jackson | Nurse Practitioner | 300 20th Ave N, Ste 301, Nashville, TN 37203-2131 | 2006-07-21 |
| 1497783146 | Tammy T. Jackson | Emergency Medicine | 2525 Desales Avenue, Chattanooga, TN 37404 | 2006-06-30 |
| 1558345371 | Tammy Z Jackson | Nurse Practitioner | 716 S Main St, Ripley, MS 38663-2909 | 2005-12-05 |
| 1275533366 | Tammy L. Jackson | Nurse Anesthetist, Certified Registered | 110 29th Ave N, Ste 202, Nashville, TN 37203-1401 | 2005-07-29 |
| Street Address |
4201 WHISPERING CREEK DR |
| City | COLLEGE STATION |
| State | TX |
| Zip Code | 77845-4054 |
| 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 Code | 103TA0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Adult Development & Aging |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355028 | Pamela Cortez Washington | Psychologist | 2819 Caroline St, Houston, TX 77004-2713 | 2020-11-01 |
| 1902427545 | Nnaemeka Nwankwo | Psychologist | 4606 Fm 1960 Rd W, Suite #224, Houston, TX 77069-4617 | 2020-05-06 |
| 1871138776 | Ikechukwu C Chidomere | Psychologist | 16731 Beechnut St Apt 206, Houston, TX 77083-6642 | 2019-11-14 |
| 1821649419 | Ashley C Boylan | Psychologist | 3628 Killian St, Fort Worth, TX 76119-3554 | 2019-09-25 |
| 1942777602 | Happy-to-help Corporation, An LLC | Psychologist | 5609 Oak Grove Rd, Fort Worth, TX 76134-2326 | 2018-10-30 |
| 1720440332 | Traneka Jackaon | Psychologist | 3620 Ginger Ln, Pearland, TX 77581-5306 | 2016-03-23 |
| 1699158873 | Nedra Helane Francis | Psychologist | 23471 Fm 450 N, Ore City, TX 75683-7005 | 2015-07-07 |
| 1326426974 | Tiffany Anthony | Psychologist | 16135 Preston Rd Ste 200, Dallas, TX 75248-8517 | 2015-05-15 |
| 1114332228 | Henry Dorsett | Psychologist | 3940 Solid Dr, Brownsville, TX 78521-4398 | 2014-06-26 |
| 1659712248 | Gems Life Skills | Psychologist | 6802 D S Bailey Ln, Houston, TX 77091-2030 | 2013-07-10 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE STATION |
| Zip Code | 77845 |
Please comment or provide details below to improve the information on DR. TAMMY LYNN JACKSON.
| 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.