NPI 1104020775

Grace Nightingale Cortez Jackson, MD

Practitioner Anatomic Pathology & Clinical Pathology Physician Austin, TX

Practice location

Address: 3445 Executive Center Drive Suite 250, Austin, TX 78731-1678
Phone: (512) 579-4000
Fax: (512) 439-2814

Registered specialties (2)

Anatomic Pathology & Clinical Pathology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207ZP0102X Licence N1690 (TX)

Other Pathology providers in Texas →

Anatomic Pathology Physician

Allopathic & Osteopathic Physicians Taxonomy 207ZP0101X Licence BP1-0016584 (TX)

Registry record

NPI: 1104020775
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Jun 2007
Record last updated: 15 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.