Paul Thomas Jackson Jr., MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K3760 Issued in TX

Practice address

4550 Lamar Ave
Suite 200
Paris, TX 75462-5124

Phone

(903) 739-2888

Fax

(903) 739-9643

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2026 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1154435899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 LAMAR AVE",
            "address_2": "SUITE 200",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754625124",
            "telephone_number": "903-739-2888",
            "fax_number": "903-739-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 LAMAR AVE",
            "address_2": "SUITE 200",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754625124",
            "telephone_number": "903-739-2888",
            "fax_number": "903-739-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PAUL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096332401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Interventional Partners PLLC
• J Keith Preston MD PA
• Samad Ahmed Jabbar, MD
• Claire Emelyn Jackson, COTA
• Jennifer Nicole Jackson, BA, LPTA
• Tonya L Jackson, NP
• Kamie Nicole James, PTA
• Marc A Jamin, ROA
• Laura Janes
• Jose A Jasso, RN

• Internal Medicine Physician in Paris, TX
• Providers in Paris, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.