IndividualActive
Chris Jackson, COTA
NPI 1124366497 · Community Health Worker · Irving, TX
Provider details
- NPI number
- 1124366497
- Entity type
- Individual
- Primary specialty
- Community Health WorkerOther Service Providers
- Credential
- COTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 209724 (TX)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6191 N State Highway 161 Ste 650
Irving, TX 75038-2250
Phone: (972) 812-3299
Approximate (ZIP-level) locationGet directions
Mailing address
2715 Columbus
Grand Prairie, TX 75054-5512
Registry dates
- Enumerated
- 2013-01-22
- Last updated
- 2013-01-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.