Provider Demographics
NPI:1245223445
Name:REXER, JENNIE L (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:L
Last Name:REXER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1515 HOLCOMBE BLVD
Mailing Address - Street 2:MD ANDERSON DEPT OF NEURO-ONCOLOGY BOX 431
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4000
Mailing Address - Country:US
Mailing Address - Phone:713-745-5051
Mailing Address - Fax:713-794-4999
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:MD ANDERSON DEPT OF NEURO-ONCOLOGY BOX 431
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-754-5051
Practice Address - Fax:713-794-4999
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX32146103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160815001Medicaid
7394526OtherAETNA PPO PRODUCTS
TX86833AOtherBCBS
TX8A9280Medicare ID - Type Unspecified