Individual
DR. JEFFREY WAYNE CARENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3901 W 15TH ST, PLANO, TX 75075-7738
(972) 867-7962
Mailing address
1820 PRESTON PARK BLVD, 1825, PLANO, TX 75093-5293
(972) 867-7862
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
M9906
TX
2085R0202X
Diagnostic Radiology Physician
2006013767
MO
2085R0202X
Diagnostic Radiology Physician
Primary
M9906
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198925301
—
TX
05
—
198925302
—
TX
01
—
8AB448
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/26/2006
Last updated
08/11/2023
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