Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1215027883 Individual Practitioner Male Practitioner

Dr. Richard J Jackson , MD

Surgery - Pediatric Surgery • Temple, TX

Professional Overview & Biography Verified Profile Summary

Dr. Richard Jackson, MD is a registered healthcare professional specializing in Surgery - Pediatric Surgery in Temple, TX. Practice services are available at 1901 SW H K DODGEN LOOP under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1901 Sw H K Dodgen Loop

Temple, TX 765023500

Telephone 2549354000
Fax 2549354111
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Pediatric Surgery in Temple, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.7 Yrs
Regional Practice Density
6 Specialists

Practicing in Temple, TX (129 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-06-08
Surgery - Pediatric Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0120X

State License TX N3094

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

Surgery - Pediatric Surgery

NUCC Taxonomy Code: 2086S0120X

State License AR N-8271

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
125912907 (TX)
Medicaid State Provider ID
137345810 (TX)
Medicaid State Provider ID
140442852 (TX)
Medicaid State Provider ID
121627001 (AR)
Medicaid State Provider ID
125912908 (TX)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1013977248

Doctor of Medicine (M.D.)

Dr. Marie Manning , MD

Emergency Medicine

NPI 1023579281

Doctor of Medicine (M.D.)

Dr. Shanti Reddy , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1073544268

Doctor of Medicine (M.D.)

Terrell Bell , CRNA

Nurse Anesthetist, Certified Registered

NPI 1083702096

Certified Registered Nurse Anesthetist

Dr. Venkata Raju , MD

Pediatrics - Neonatal-Perinatal Medicine

NPI 1093788481

Doctor of Medicine (M.D.)

Joyce Gardner , CRNA

Nurse Anesthetist, Certified Registered

NPI 1114066016

Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location October 14, 2019

Registered at 1901 SW H K DODGEN LOOP, TEMPLE, TX 765023500 (Tel: 2549354000)

📍
Updated Business Mailing Address October 14, 2019

Registered at PO BOX 844658, DALLAS, TX 752844658 (Tel: 2547242111)

NPI Profile Active February 05, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location February 05, 2014

Registered at 1 CHILDRENS WAY # 653, LITTLE ROCK, AR 722023500 (Tel: 5013641100)

📍
Updated Business Mailing Address February 05, 2014

Registered at 1 CHILDRENS WAY # 653, LITTLE ROCK, AR 722023500 (Tel: 5013641100)

👤
Provider Name / Credentials Updated February 05, 2014

Recorded as RICHARD JACKSON, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2014

Surgery (License #N-8271 in AR)

🟢
Initial NPI Registration & Enumeration October 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Richard Jackson. Be the first to share your experience!

Sign in to leave a review for Dr. Richard Jackson

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1215027883
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 13, 2006
Last Update: June 08, 2021
Sole Proprietor: No

Mailing Address

Po Box 844658

Dallas, TX 752844658

Phone: 2547242111

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.