Provider Demographics
NPI:1407824519
Name:KERNER, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:KERNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 W PARKER RD
Mailing Address - Street 2:SUITE 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:SUITE 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
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9663208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA03ZMedicare ID - Type Unspecified
TXB23909Medicare UPIN