Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Detra L Jackson

Individual provider Driver · NPI 1558206359

Detra L Jackson is a Driver in Dallas, Texas. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
6
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Practice location Address checks out

1910 Pacific Ave Ste 20001046
Dallas, TX 75201-4529
Phone: (305) 988-7335
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X
Driver Taxonomy 172A00000X
Community/Behavioral Health Agency Taxonomy 251S00000X
Adult Care Home Facility Taxonomy 311ZA0620X
Intellectual Disabilities Intermediate Care Facility Taxonomy 315P00000X
Mental Illness Community Based Residential Treatment Facility Taxonomy 320800000X

Record details

NPI number1558206359
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 20, 2026
Last updated in NPPESApril 20, 2026
Certification dateApril 20, 2026
Mailing address1910 Pacific Ave Ste 20001046, Dallas, TX 75201-4529

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