DR. TRACIE JACKSON (NPI# 1982883609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1982883609 |
Entity Type | Individual |
Full Name | DR. TRACIE JACKSON |
Credential | D.D.S. |
Practice Address |
1507 W League City Pkwy Ste 100 League City TX 77573-7340 |
Practice Telephone | 2813328400 |
Practice Fax Number | 2814766429 |
Mailing Telephone | 2813328400 |
Mailing Fax Number | 2814766429 |
Enumeration Date | 2007-10-30 |
Last Update Date | 2019-05-30 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
22852 | TX | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932458346 | Tracie Lynn Jackson | Nurse Practitioner | 740 S Limestone St Perioperative Services, Suite J111, Lexington, KY 40536-0200 | 2012-08-30 |
1275181414 | Tracie Latrice Jackson | Chore Provider | 3620 N Rancho Dr Ste 117, Las Vegas, NV 89130-3154 | 2019-08-30 |
1184167751 | Tracie Jackson | Physical Therapy Assistant | 6300 Sw 6th Ave, Topeka, KS 66615-1013 | 2016-11-29 |
1487948154 | Tracie Lashelle Jackson | Physical Therapist | 10101 Park Rowe Ave, Ste. 200, Baton Rouge, LA 70810-1686 | 2011-05-31 |
1982807715 | Tracie Lee Jackson | Dietitian, Registered | 8601 W Dodge Rd, Suite # 30, Omaha, NE 68114-3457 | 2007-06-08 |
1518997196 | Tracie Deneice Jackson | Counselor | 6005 Financial Plz, Shreveport, LA 71129-2615 | 2006-07-03 |
Street Address |
1507 W LEAGUE CITY PKWY STE 100 |
City | LEAGUE CITY |
State | TX |
Zip Code | 77573-7340 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811555345 | Westview Dental | Clinic/Center | 1507 W League City Pkwy Ste 100, League City, TX 77573-7340 | 2019-05-30 |
1356726814 | Ashley Tucker | Dentist | 1507 W League City Pkwy Ste 100, League City, TX 77573-7340 | 2015-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114527306 | Colin Joe Lee | Pharmacist | 1088 W Main St League City, Tx 77573 United States, League City, TX 77573 | 2020-10-28 |
1033764931 | Brittany Salinas | Physical Medicine & Rehabilitation | 2205 Colonial Court N, League City, TX 77573 | 2019-08-07 |
1366007833 | Tmh Physician Associates Pllc | Orthopaedic Surgery | 2220 E. League City Parkway, Suite 200, League City, TX 77573 | 2019-05-09 |
1851863724 | Gina Carter | Durable Medical Equipment & Medical Supplies | 210 S. Hwy 3, Unit B, League City, TX 77573 | 2018-12-17 |
1497226393 | Daniel Max & Marcandrea LLC | Optometrist | 3170 Gulf Freeway South, League City, TX 77573 | 2018-12-17 |
1972071983 | Chelsie N Chonoski | Nurse Practitioner | 2240 Gulf Freeway South, Suite 2.110, League City, TX 77573 | 2018-11-07 |
1730660564 | Rebecca Ann Peth | Physical Therapist | 350 N Wesley Dr., Apt 1123, League City, TX 77573 | 2018-08-29 |
1912485087 | Sarwat Hussain Zaffer | Dentist | 1620 W Fm 646, Ste D, League City, TX 77573 | 2018-08-01 |
1518468651 | Clear Creek Chiropractic Center | Clinic/Center | 624 West Main Ste 102, League City, TX 77573 | 2018-02-23 |
1255850848 | Travis William Prothro | Chiropractor | 1620 W. Fm 646, Suite C, League City, TX 77573 | 2017-09-14 |
Find all providers in zip 77573 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518572114 | Erick Daniel Lopez | Dentist | 1355 E League City Pkwy Ste 500, League City, TX 77573-7096 | 2020-09-10 |
1861054991 | Emily D'aun Donnell | Dentist | 3033 Marina Bay Dr Ste 230, League City, TX 77573-3982 | 2019-06-28 |
1356860316 | Portable Smiles LLC | Dentist | 141 S Laguna Pointe Dr, League City, TX 77573-9004 | 2017-09-11 |
1508206079 | Thien-kim Thi Pham | Dentist | 2508 Gulf Fwy S Ste 108, League City, TX 77573-6743 | 2013-06-28 |
1225385875 | League City Modern Dentistry and Orthodontics, PC | Dentist | 1620 West Fm 646 Suite D, League City, TX 77573 | 2012-08-13 |
1992099238 | Yu Gan | Dentist | 4611 Miramar Dr, League City, TX 77573-1452 | 2011-06-03 |
1871757039 | Maria Cristina Abramian | Dentist | 2640 E League City Pkwy Ste 108, League City, TX 77573 | 2008-07-16 |
1609034727 | Dr Gary Geaccone | Dentist | 608 B West Main, League City, TX 77573 | 2008-05-27 |
1669667408 | Dental Etc | Dentist | 2945 Gulf Fwy S Ste D, League City, TX 77573-6771 | 2007-09-13 |
1790900306 | Jeffrey Brian Geno | Dentist | 216 Interstate 45 South, League City, TX 77573 | 2007-04-17 |
Find all providers in LEAGUE CITY |
City | LEAGUE CITY |
Zip Code | 77573 |
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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.