Individual
DIANE JENDRZEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8366 N LOOP 1604 W, STE 105, SAN ANTONIO, TX 78249-3533
(210) 680-6000
(210) 680-9153
Mailing address
333 N SANTA ROSA ST, STE D4023, SAN ANTONIO, TX 78207-3108
(469) 282-2711
(469) 282-2609
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G8199
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136388904
—
TX
05
—
136388908
—
TX
05
—
136388910
—
TX
01
—
1790764983
NPI
TX
01
—
87460G
BCBS
TX
Enumeration date
01/16/2006
Last updated
10/31/2016
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