Individual
DR. JERI L PENKAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
G4242
TX
208000000X
Pediatrics Physician
G4242
TX
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
G4242
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121517009
—
TX
01
—
347259
PTAN
TX
Enumeration date
12/29/2006
Last updated
04/09/2026
Update your record
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