Individual provider · Type 1 NPI

Nicole Etta Jackson, DO

Family Medicine Physician · Dallas, TX

NPI number 1578084927 Active

Practice location

325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923

Call (617) 505-1520 Map

Fax (617) 928-8401

Mailing address

109 State St Ste 5
Boston, MA 02109-2906

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000X2020-04019 (NC)
Family Medicine Physician 207Q00000X009754 (GA)
Family Medicine Physician Primary 207Q00000XW7943 (TX)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1578084927

Nicole Etta Jackson, DO's National Provider Identifier is 1578084927, issued on Jul 6, 2017. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Dallas, TX. The record was last updated on Sep 25, 2026.