Individual
JENNIFER DIANE BRODY
Active
Individual
JENNIFER DIANE BRODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M1536
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
M1536
TX
207RP1001X
Pulmonary Disease Physician
Primary
M1536
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1995102-02
—
TX
Enumeration date
09/20/2005
Last updated
02/01/2015
Update your record
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