Individual provider · Type 1 NPI

Latasha Jackson

Prosthetic/Orthotic Supplier · Houston, TX

NPI number 1124940374 Active

Practice location

6220 Westpark Dr Ste 149J
Houston, TX 77057-7371

Specialties and licenses

Taxonomy	Code	License
Prosthetic/Orthotic Supplier Primary	335E00000X	None listed

Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

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About NPI 1124940374

Latasha Jackson's National Provider Identifier is 1124940374, issued on Jul 29, 2026. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Houston, TX. The record was last updated on Jul 29, 2026.