Provider Demographics
NPI:1760940563
Name:ABOVE AVERAGE HEALTH AND HOUSE CALLS LLC
Entity Type:Organization
Organization Name:ABOVE AVERAGE HEALTH AND HOUSE CALLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTAILIST
Authorized Official - Prefix:
Authorized Official - First Name:ALBA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-417-4595
Mailing Address - Street 1:445 E FM 1382 STE 3
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:989 WINNING COLORS DR
Practice Address - Street 2:
Practice Address - City:WILMER
Practice Address - State:TX
Practice Address - Zip Code:75172-2336
Practice Address - Country:US
Practice Address - Phone:469-494-7725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty