Individual
DR. JENNIFER R STALKUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6100 WINDHAVEN PKWY, PLANO, TX 75093-8046
(214) 615-1900
(214) 615-1800
Mailing address
5016 MILAM ST, DALLAS, TX 75206-6512
(214) 615-1900
(214) 615-1800
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M1368
TX
207NP0225X
Pediatric Dermatology Physician
M1368
TX
207NS0135X
Procedural Dermatology Physician
M1368
TX
Other
Enumeration date
06/27/2006
Last updated
03/15/2021
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