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Individual

DR. JEFFREY CRAIG KOMENDA

Active
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Individual

DR. JEFFREY CRAIG KOMENDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H6350
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10018514
AMERIGROUP
TX
05
—
124934405
—
TX
01
—
165802301
MEDICAID GROUP
TX
01
—
165802302
MEDICAID TEXAS HEALTH STE
TX
Enumeration date
10/19/2007
Last updated
08/30/2024
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