Provider Demographics
NPI:1477684520
Name:JACKSON, AKINIA MONEE
Entity Type:Individual
Prefix:
First Name:AKINIA
Middle Name:MONEE
Last Name:JACKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12655 CROSSROADS PARK DR
Mailing Address - Street 2:#121
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3375
Mailing Address - Country:US
Mailing Address - Phone:281-894-2592
Mailing Address - Fax:
Practice Address - Street 1:5850 SAN FELIPE ST
Practice Address - Street 2:500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3070
Practice Address - Country:US
Practice Address - Phone:713-706-6180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist