Individual
SERENA JEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
816 W CANNON ST, FORT WORTH, TX 76104-3194
(817) 321-0404
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3194
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD210001924
DC
2085R0202X
Diagnostic Radiology Physician
Primary
R9783
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
TN
Other
Enumeration date
05/11/2017
Last updated
12/14/2022
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