Individual
DENA L CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4916 OVERTON PLZ, FORT WORTH, TX 76109-4415
(800) 480-1819
Mailing address
PO BOX 50667, AMARILLO, TX 79159-0667
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
L9154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168273401
—
TX
Enumeration date
07/05/2006
Last updated
02/05/2009
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