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Contact Information

SHAUN C JACKSON, MD
423 TREELINE PARK
SUITE 325
SAN ANTONIO, TX78209-2060
 Phone: 210-805-9800
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for SHAUN C JACKSON · (Male)

NPI Number 1407013691
Status Active
Credentials MD
Entity Individual
Enumeration date 05/16/2008
Last updated 06/03/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • TX License # M9372
  • TX Medicaid 1984007-01
  • TX Other M9372 MEDICAL LICENSE
  • TX Other 8L0027 MEDICARE PTAN
Hospital affiliation(s)
  • BAPTIST MEDICAL CENTER - (Acute Care)
    111 DALLAS STREET
    SAN ANTONIO, TX 78205
  • CHRISTUS SANTA ROSA HOSPITAL - (Acute Care)
    333 NORTH SANTA ROSA STEET
    SAN ANTONIO, TX 78207
  • FOUNDATION SURGICAL HOSPITAL OF SAN ANTONIO - (Acute Care)
    9522 HUEBNER ROAD
    SAN ANTONIO, TX 78240
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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