Provider Demographics
NPI:1417152000
Name:ARNOUVILLE, JENNIFER THOMPSON (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:THOMPSON
Last Name:ARNOUVILLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:C
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5450 CLEARFORK MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3559
Mailing Address - Country:US
Mailing Address - Phone:817-334-1400
Mailing Address - Fax:
Practice Address - Street 1:5450 CLEARFORK MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-3559
Practice Address - Country:US
Practice Address - Phone:817-334-1400
Practice Address - Fax:817-334-1410
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9812207QG0300X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217170402Medicaid
TX217170401Medicaid
TX217170402Medicaid
TXTXB110710Medicare PIN