Individual
DR. BECKY JO ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-3382
Mailing address
UTSW BILLING, PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-0600
(214) 645-2762
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
L4364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185939901
—
TX
Enumeration date
06/11/2006
Last updated
04/04/2012
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