Organization
JEFFREY C. KOMENDA, M.D., P.A.
Active
Other names
Family Medicine at Willow Bend
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY CRAIG KOMENDA M.D. (MEDICAL DOCTOR)
(972) 608-1868
Entity
Organization
Contact information
Practice address
5944 W PARKER RD, SUITE 100, PLANO, TX 75093-6421
(972) 608-1868
(972) 943-8644
Mailing address
5944 W PARKER RD, PLANO, TX 75093-6422
(972) 608-1868
(972) 943-8644
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
H6350
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10018514
AMERIGROUP
TX
05
—
124934405
—
TX
05
—
165802301
—
TX
05
—
165802302
—
TX
Enumeration date
08/31/2005
Last updated
02/28/2012
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