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

Theresa Jackson, MD

Individual provider Surgery Physician · NPI 1164818993

Theresa Jackson, MD is a General Surgery in Tulsa, Oklahoma. Graduated from University of Oklahoma College of Medicine in 2015, 11 years ago. Practices with Las Cruces Physician Practices, LLC, a 108-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oklahoma and Texas.

Years since qualifying
11
Trained at
University of Oklahoma College of Medicine
Licensed in
OK, TX
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4629 E 13th Pl
Tulsa, OK 74112-6103
Phone: (405) 822-8297
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 32423 (OK)
Surgery Physician Taxonomy 208600000X · Licence BP10052439 (TX)

Record details

NPI number1164818993
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 8, 2015
Last updated in NPPESJuly 11, 2024
Certification dateJuly 11, 2024
Mailing address4629 E 13th Pl, Tulsa, OK 74112-6103

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Las Cruces Physician Practices, Llc — 108 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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