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

Mr. Micah Roy Jackson, PA

Individual provider Physician Assistant · NPI 1558665703

Mr. Micah Roy Jackson, PA is a Physician Assistant in Tyler, Texas. Licensed in Texas. Registered with an NPI since 2011.

Licensed in
TX
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

1814 Roseland Blvd Ste 200
Tyler, TX 75701-4234
Phone: (903) 592-6000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA06963 (TX)

Record details

NPI number1558665703
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 3, 2011
Last updated in NPPESApril 19, 2016

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