WARREN T JACKSON PHD
NPI 1396773750
Clinical Neuropsychologist in Dallas, TX

Q: What is Warren Jackson's NPI number?

The NPI number for Warren Jackson is 1396773750. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Q: What is Warren Jackson's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: Is Warren Jackson enrolled in Medicare?

No. Warren Jackson has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Warren Jackson was last updated on April 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 28, 2006Opted out of Medicare · through Oct 1, 2027

3600 GASTON AVE, 1155 WADLEY TOWER, DALLAS, TX 75246(214) 820-5516(214) 820-5518 Get Directions Write a Review

NPPES record last updated: April 4, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Warren T Jackson Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WARREN T JACKSON PHD (NPI 1396773750) is an individual clinical neuropsychologist in Dallas, Texas, licensed in Texas (33275) and active in the NPI registry since June 2006. He has opted out of Medicare through October 1, 2027.

NPPES Registry Identity

NPI1396773750

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameWARREN T JACKSONCredential: PHD

Location Address3600 GASTON AVE, 1155 WADLEY TOWERDallas, TX 75246-1800

Mailing Address3600 Gaston Ave, 1155 Wadley TowerDallas, TX 75246-1800 · (214) 820-5516 · Fax (214) 820-5518

Phone(214) 820-5516

Fax(214) 820-5518

Sole ProprietorNo

Enumeration DateJune 28, 2006

Last NPPES UpdateApril 4, 2022

NPPES CertifiedApril 4, 2022

✔ NPI 1396773750 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in TX · 33275

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

3600 GASTON AVE, Dallas, TX 75246

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Warren T Jackson Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2025 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2025

Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MAMTA GUPTA MD

Internal Medicine

3600 GASTON AVE, SUITE 550
DALLAS, TX 75246

Dallas County (214) 821-8867

DR. ARIEL MARCELO MODRYKAMIEN M.D.

Internal Medicine (Pulmonary Disease)

3600 GASTON AVE, WADLEY TOWER, SUITE 960
DALLAS, TX 75246

Dallas County (402) 972-6078

SUSAN C. CHESIRE ANP

Nurse Practitioner (Adult Health)

3600 GASTON AVE, WADLEY TOWER, SUITE 651
DALLAS, TX 75246

Dallas County (214) 820-9115

DR. SADAT ANWAR SHAMIM M.D.

Psychiatry & Neurology (Neurology)

3600 GASTON AVE, SUITE 1155
DALLAS, TX 75246

Dallas County (214) 820-4688

KIMBER LEE FOUST MD

Internal Medicine (Critical Care Medicine)

3600 GASTON AVE, WADLEY TOWER STE 960
DALLAS, TX 75246

Dallas County (214) 820-5630

TEXAS SAM HOLDINGS, LLC

Clinic/Center (Sleep Disorder Diagnostic)

3600 GASTON AVE, SUITE 1055
DALLAS, TX 75246

Dallas County (214) 827-0330

DR. CARLOS E VELASCO MD

Internal Medicine (Interventional Cardiology)

3600 GASTON AVE, SUITE 851
DALLAS, TX 75246

Dallas County (214) 826-6044

ROBERT LOUIS KOSTER M.D.

Internal Medicine

3600 GASTON AVE, SUITE 703
DALLAS, TX 75246

Dallas County (214) 823-4200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Warren Jackson's NPI number?

The NPI number for Warren Jackson is 1396773750. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Warren Jackson located?

Warren Jackson practices at 3600 Gaston Ave 1155 Wadley Tower, Dallas, TX 75246. The listed phone number is (214) 820-5516.

What is Warren Jackson's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Warren Jackson enrolled in Medicare?

No. Warren Jackson has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Warren Jackson was last updated on April 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.