Individual
JENNIFER MICHELLE KRESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16605 SOUTHWEST FWY STE 450, SUGAR LAND, TX 77479-3505
(281) 275-0860
Mailing address
16811 SOUTHWEST FWY STE 450, SUGAR LAND, TX 77479-4728
(281) 275-0860
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
BP10037827
TX
208600000X
Surgery Physician
BP2-0041560
TX
208600000X
Surgery Physician
Primary
Q6860
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP2-0041560
PHYSICIAN IN TRAINING LICENSE
TX
01
—
Q6860
TX STATE LICENSE
TX
Enumeration date
06/03/2010
Last updated
03/01/2024
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