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

Mr. Shane Jackson, OWNER

Individual provider Physical Therapist · NPI 1699495812

Mr. Shane Jackson, OWNER is a Physical Therapist in Hurst, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2022

Practice location Address checks out

1717 Precinct Line Rd Ste 204
Hurst, TX 76054-3169
Phone: (817) 479-7263
Fax: (817) 479-3954
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1310272 (TX)

Record details

NPI number1699495812
Entity typeIndividual (Type 1)
GenderMale
Credentials OWNER
Sole proprietorYes
NPI enumeratedAugust 29, 2022
Last updated in NPPESAugust 29, 2022
Certification dateAugust 29, 2022
Mailing address1717 Precinct Line Rd Ste 204, Hurst, TX 76054-3169

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