Provider Demographics
NPI:1235437690
Name:ELIZABETH KERNER, M.D., P.A.
Entity Type:Organization
Organization Name:ELIZABETH KERNER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:NMI
Authorized Official - Last Name:KERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-981-7144
Mailing Address - Street 1:6130 W PARKER RD
Mailing Address - Street 2:STE 110
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7912
Mailing Address - Country:US
Mailing Address - Phone:972-981-7144
Mailing Address - Fax:972-981-3265
Practice Address - Street 1:6130 W PARKER RD
Practice Address - Street 2:STE 110
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7912
Practice Address - Country:US
Practice Address - Phone:972-981-7144
Practice Address - Fax:972-981-3265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF96632086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00A03ZMedicare PIN
TXB23909Medicare UPIN