Shane Jackson, OWNER

Physical Therapist · Hurst, TX

Individual Active NPI

NPI number 1699495812

Practice location

1717 Precinct Line Rd Ste 204
Hurst, TX 76054-3169
Phone
(817) 479-7263
Fax
(817) 479-3954

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NPI record

NPI
1699495812
Entity type
Individual (Type 1)
Enumeration date
August 29, 2022
Last updated
August 29, 2022
Certified
August 29, 2022
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapist Primary 225100000X 1310272 TX

About Shane Jackson

Shane Jackson, OWNER is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapist (code 225100000X). The practice location is 1717 Precinct Line Rd Ste 204, Hurst, TX 76054-3169. The NPI number 1699495812 was assigned on August 29, 2022 and the record was last updated on August 29, 2022.

Shane Jackson lists a license in the registry: #1310272 (TX) for Physical Therapist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Shane Jackson, OWNER?

The NPI number is 1699495812.

What is the phone number of Shane Jackson?

The phone number listed for the practice location is (817) 479-7263.

Where is Shane Jackson located?

1717 Precinct Line Rd Ste 204, Hurst, TX 76054-3169.

What is the taxonomy code for Shane Jackson?

The primary taxonomy code is 225100000X – Physical Therapist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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