Provider Demographics
NPI:1407888068
Name:JACKSON, JULIA CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:CHRISTINE
Last Name:JACKSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26254 INTERSTATE 10 W STE 140
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-6503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26254 INTERSTATE 10 W STE 140
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-6503
Practice Address - Country:US
Practice Address - Phone:210-455-0444
Practice Address - Fax:830-255-5966
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT49392084P0804X
OH350824632084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry