Individual
EDWIN PATRICK JENEVEIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5909 HARRY HINES BLVD, DALLAS, TX 75235-6209
(214) 645-5382
(214) 645-3537
Mailing address
8267 ELMBROOK DR, SUITE 100, DALLAS, TX 75247-4030
(214) 237-1664
(214) 237-1864
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C9220
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80P356
BCBS
TX
Enumeration date
07/20/2006
Last updated
07/09/2007
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