Individual
SHERRY R KONDZIELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1307 8TH AVE, SUITE 100, FORT WORTH, TX 76104
(817) 284-9850
Mailing address
PO BOX 733332, DALLAS, TX 75373-3332
(817) 284-9850
(817) 284-3425
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J3520
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128454909
—
TX
01
—
848661
BCBS
TX
Enumeration date
02/02/2006
Last updated
02/01/2022
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