Look up the most recent NPI and PECOS records

Masheika S Jackson

Family Medicine

Allopathic & Osteopathic Physicians

1500 S Main St, Attention: Academic Affairs, Fort Worth, TX 76104-4917

PECOS Enrollment

This provider is enrolled in PECOS as MASHEIKA JACKSON.

Based on the most recent information from CMS, provider Masheika S Jackson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1073757357
Provider Type
Individual
Full Name
Jackson, Masheika S
Credential
D.O.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/30/2009
Last Updated
4/30/2009

Contact Information

Practice Location

1500 S Main St, Attention: Academic Affairs, Fort Worth, TX 76104-4917

(817) 921-3431

Unlisted Fax

Mailing Location

1500 S Main St, Attention: Academic Affairs, Fort Worth, TX 76104-4917

(817) 921-3431

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License BP10030927 Texas

Masheika S Jackson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Foran, Laine F

Texas Health Care, P.L.L.C.

Godwin, Victoria Ashley

Abilez, Cristianna Alicia

Greer, Daria Katherine

Wix, Kurtt R

Bullock, Dana Jill

Rasheed, Nida

Edwards, Ricky D

Vilaythong, Alexander P.