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Jeffrey C. Komenda, M.d., P.a.
Clinic/Center in Lewisville, Texas
NPI 1972788628

Jeffrey C. Komenda, M.d., P.a. is a Clinic/Center based in Plano, TX. Jeffrey C. Komenda, M.d., P.a. practices in Lewisville, TX. The NPI Number for Jeffrey C. Komenda, M.d., P.a. is 1972788628 and holds a License No. H6350 (Texas).

The current practice location address for Jeffrey C. Komenda, M.d., P.a. is 1305 S Sh 121, Lewisville, TX and can be reached out via phone at 972-608-1868 and via fax at 972-943-8644.

Location: 1305 S Sh 121, Lewisville, TX, 75093-6422
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1972788628
Provider Name
Jeffrey C. Komenda, M.d., P.a.
Credential
Provider Entity Type
Organization
Address
1305 S Sh 121, Lewisville, TX, 75093-6422
Phone Number
972-608-1868
Fax Number
972-943-8644
Provider Enumeration Date
12/31/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
165802301 05 TX
165802302 01 TX MEDICAID HEALTH STEPS
10018514 01 TX AMERIGROUP
8AJ618 01 TX BC/BS INDIVIDUAL
0007QN 01 TX BC/BS GROUP NUMBER
institution
Provider Business Practice Location Address Details
Address
1305 S Sh 121
City
Lewisville
State
Texas
Zip
75067-5915
Phone Number
972-608-1868
Fax Number
972-943-8644
person
Provider Business Mailing Address Details
Address
1305 S Sh 121
City
Lewisville
State
Texas
Zip
75067-5915
Phone Number
972-608-1868
Fax Number
972-943-8644
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
H6350 (Texas)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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