Provider Demographics
NPI:1821093493
Name:BIGGS, JACKSON T (MD)
Entity Type:Individual
Prefix:DR
First Name:JACKSON
Middle Name:T
Last Name:BIGGS
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 1:161 LAY ST
Mailing Address - Street 2:
Mailing Address - City:HALLETTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77964-3519
Mailing Address - Country:US
Mailing Address - Phone:361-798-5168
Mailing Address - Fax:
Practice Address - Street 1:161 LAY ST
Practice Address - Street 2:
Practice Address - City:HALLETTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77964-3519
Practice Address - Country:US
Practice Address - Phone:361-798-5168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE95412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760129220OtherCOMMERCIAL
TX0003JTOtherBLUE CROSS BLUE SHIELD
TX76012922077964A001OtherTRICARE
TX0003JTOtherBLUECROSS/SHIELD GROUP ID
TX144710401Medicaid
TXE9541OtherUNICARE CLASSIC
TXB21268OtherOTHER GROUP ID
TX144710401Medicaid
TX0003JTOtherBLUECROSS/SHIELD GROUP ID
TXE9541OtherUNICARE CLASSIC
TX00452QMedicare ID - Type Unspecified