Individual
JENNIFER L. MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2710 SWISS AVE, DALLAS, TX 75204-5900
(148) 211-5992
(214) 821-8985
Mailing address
2710 SWISS AVE, DALLAS, TX 75204-5900
(214) 821-1599
(214) 821-8985
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
205553
LA
208600000X
Surgery Physician
N7301
TX
2086S0102X
Surgical Critical Care Physician
205553
LA
2086S0102X
Surgical Critical Care Physician
N7301
TX
2086S0127X
Trauma Surgery Physician
Primary
205553
LA
2086S0127X
Trauma Surgery Physician
N7301
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2304178
—
LA
Enumeration date
06/13/2007
Last updated
10/23/2018
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