Antonious Dewayne Jackson, DC, FNP-C is a
Nurse Practitioner - Family based in Bedford, Texas. Antonious Dewayne Jackson is licensed to practice in Texas (license number AP133741) and his current practice location is
2900 Highway 121 Ste 120, Bedford, Texas. He can be reached at his office (for appointments etc.) via phone at
(817) 921-3000.
NPI number for Antonious Dewayne Jackson is 1205037322 and his current mailing address is Po Box 627, Hurst, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1205037322.
Healthcare Provider's Profile
Full Name | Antonious Dewayne Jackson |
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Gender | Male |
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Speciality | Nurse Practitioner - Family |
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Location | 2900 Highway 121 Ste 120, Bedford, Texas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1205037322
- Provider Enumeration Date: 05/29/2007
- Last Update Date: 04/12/2017
Medical Identifiers
Medical identifiers for Antonious Dewayne Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205037322 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
111NR0400X | Chiropractor - Rehabilitation | DC9074 (Texas) | Secondary |
363LF0000X | Nurse Practitioner - Family | AP133741 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Antonious Dewayne Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Antonious Dewayne Jackson, DC, FNP-C Po Box 627, Hurst, TX 76053-0627 Ph: (817) 770-3565 | Antonious Dewayne Jackson, DC, FNP-C 2900 Highway 121 Ste 120, Bedford, TX 76021-4033 Ph: (817) 921-3000 |
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