Individual
MRS. JOANNE M. CELENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7777 FOREST LN, SUITE A307, DALLAS, TX 75230-2571
(972) 566-4866
(972) 566-2469
Mailing address
11970 N CENTRAL EXPY STE 520, DALLAS, TX 75243-3768
(972) 566-4866
(972) 566-2469
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
0110002198
VA
363AS0400X
Surgical Physician Assistant
Primary
AP08625
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010222796
—
VA
01
—
203639329
TRICARE PROVIDER NUMBER
—
Enumeration date
12/21/2005
Last updated
01/04/2022
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