Individual
JENNIFER A LUNCEFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1730 B F TERRY BLVD STE 302, ROSENBERG, TX 77471-5535
(866) 989-2873
(713) 568-3313
Mailing address
108 PENNY LN, ATHENS, TX 75751-3244
(903) 386-3386
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02328
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187881104
—
TX
01
—
7057548
AETNA
TX
01
—
75-1976930-005
TRICARE
TX
01
—
8192NP
BCBS
TX
01
—
8821NF
BCBS
TX
01
—
P01492565
RAIL ROAD
TX
Enumeration date
06/30/2006
Last updated
08/28/2024
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