Individual
JANICE A KNEBL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2660
(817) 735-5441
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2660
(817) 735-5441
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
H4979
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
H4979
TX
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
H4979
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118453302
—
TX
01
—
380000251
RAILROAD MEDICARE
TX
01
—
842577
BCBS
TX
Enumeration date
04/17/2006
Last updated
07/20/2017
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