Individual
DR. JENNIFER LYNNE DUEWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4001 W 15TH ST, SUITE 245, PLANO, TX 75093-5841
(972) 596-5222
(972) 596-5291
Mailing address
4001 W 15TH ST, SUITE 245, PLANO, TX 75093-5841
(972) 596-5222
(972) 596-5291
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N8091
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301724602
—
TX
Enumeration date
04/05/2008
Last updated
10/23/2019
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