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Contact Information

DANETTE M JACKSON, DO
BLDG 2245, 761ST TANK DESTROYER BLVD
CHARLES THOMAS MOORE CLINIC
FT CAVAZOS, TX76544
 Phone: 254-285-6232
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for DANETTE M JACKSON · (Female)

NPI Number 1083717078
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 09/06/2006
Last updated 08/14/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IA License # DO-02419
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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