Organization
OFFICE OF SHERRY KONDZIELA, MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY R KONDZIELA MD (PRESIDENT)
(817) 284-9850
Entity
Organization
Contact information
Practice address
1307 8TH AVE, SUITE 100, FORT WORTH, TX 76104-4137
(817) 284-9850
(817) 921-4406
Mailing address
1307 8TH AVE, SUITE 100, FORT WORTH, TX 76104-4137
(817) 921-4400
(817) 921-4406
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J3520
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F5Z2
BCBS
TX
05
—
364011201
—
TX
Enumeration date
04/21/2016
Last updated
03/31/2025
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