Active NPI
Shaunda Lynn Jackson
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Humble, TX
National Provider Identifier
1891394102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 34150
- Practice address
- 19250 W Lake Houston Pkwy
Humble, TX 77346-2279 - Phone
- (281) 541-6265
- NPI assigned
- Oct 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 34150 | TX | Primary |
Addresses
Primary practice location
19250 W Lake Houston Pkwy
Humble, TX 77346-2279
Mailing address
19250 W Lake Houston Pkwy
Humble, TX 77346-2279
Phone (281) 541-6265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34150 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1891394102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19250 W LAKE HOUSTON PKWY",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773462279",
"telephone_number": "281-541-6265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19250 W LAKE HOUSTON PKWY",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773462279",
"telephone_number": "281-541-6265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SHAUNDA",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-19",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "34150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.