Provider Demographics
NPI:1316300866
Name:JACKSON, CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:JACKSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19106 US HIGHWAY 281 N STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4988
Mailing Address - Country:US
Mailing Address - Phone:210-953-0840
Mailing Address - Fax:210-783-1991
Practice Address - Street 1:19106 US HIGHWAY 281 N STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4988
Practice Address - Country:US
Practice Address - Phone:210-953-0840
Practice Address - Fax:210-783-1991
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE308382084P0800X, 208D00000X
TXV44072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice