NPI age
15 years
Enumerated 2011-03-23
● Active
Type 1 · Individual
Kyle Jefferson Jackson, D.O.
Jackson is 1 of 11 internal medicine providers in Tyler and 1 of 935 in Texas.
Primary specialty
Internal Medicine
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2025-04-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 935 active internal medicine providers in Texas.
NPI age
15 years
↓ 3 yr below median (18 yr)
State licenses
1 state
15% of peers hold multiple states
Subspecialties
0
38% of peers hold subspecialties
NPI lifetime · 2011 → 2026
2011-03Enumerated in NPPES
2011
2026
Where they practice
Practice location
619 S Fleishel Ave, Suite 327
Tyler, TX 757012004
Mailing address
619 S Fleishel Ave, Suite 327
Tyler, TX 757012004
Additional practice locations
1 secondary location on file with NPPES.
Location 2
1327 Troup Hwy
Tyler, TX 757014443
Specialties
-
Internal Medicine PrimaryAn internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 75-2616977-123 | TRICARE |
| 01 (TX) | P01697215 | RAIL ROAD MEDICARE |
| 05 (TX) | 360453001 | |
| 01 (TX) | 8GA283 | BCBS |
Practice context
Part of a multi-provider practice. 19 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.