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Organization

JEFFREY C. KOMENDA, M.D., P.A.

Active
Parent organization
JEFFREY C. KOMENDA, M.D., P.A.
Other names
Best Choice Medical Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
JEFFREY C. KOMENDA, M.D., P.A.
Authorized official
MRS. TAMMY TICKLE KOMENDA (OFFICE MANAGER)
(972) 608-1868
Entity
Organization

Contact information

Practice address
1305 S SH 121, STE C-108, LEWISVILLE, TX 75067-5915
(972) 608-1868
(972) 943-8644
Mailing address
5944 W PARKER RD STE 100, PLANO, TX 75093-6422
(972) 608-1868
(972) 943-8644

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
H6350
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007QN
BC/BS GROUP NUMBER
TX
01
10018514
AMERIGROUP
TX
05
165802301
TX
01
165802302
MEDICAID HEALTH STEPS
TX
01
8AJ618
BC/BS INDIVIDUAL
TX
Enumeration date
12/31/2007
Last updated
08/11/2008
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