Provider Demographics
NPI:1164675088
Name:JENNIFER L. STAUD M.D.P.A.
Entity Type:Organization
Organization Name:JENNIFER L. STAUD M.D.P.A.
Other - Org Name:JENNIFER L.STAUD M.D.P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:STAUD
Authorized Official - Suffix:
Authorized Official - Credentials:MDPA
Authorized Official - Phone:972-401-3200
Mailing Address - Street 1:701 TUSCAN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3834
Mailing Address - Country:US
Mailing Address - Phone:972-401-3200
Mailing Address - Fax:972-401-3230
Practice Address - Street 1:701 TUSCAN
Practice Address - Street 2:SUITE 200
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3834
Practice Address - Country:US
Practice Address - Phone:972-401-3200
Practice Address - Fax:972-401-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2827207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty