Mary Jackson is one of 280 nurse practitioners practicing in Beaumont, Texas .
Mary Jackson practices with Southeast Texas Intensivists, PLLC.
Registry record (NPPES)
NPI
1124419015
Type
Type 1 · Individual
Primary taxonomy
Nurse Practitioner, Acute Care · 363LA2100X
Address on file
5201 Harry Hines Blvd
Enumerated
Feb 12, 2015
Record last updated
Sep 3, 2019
License states listed
OK, TX
Medicare (CMS)
Enrollment
Medicare-enrolled in TXNurse Practitioner
Revalidation due
No date set by CMS
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Part D prescribing
Procedure volumes by CPT code
Group affiliations and colleagues
Full enrollment history
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Practice locations
2830 Calder StBeaumont , TX 77702
More nurse practitioners in Beaumont
Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.
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