Provider Demographics
NPI:1497720916
Name:HARPER, JENNIFER ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ALEXANDER
Last Name:HARPER
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 1:4517 GRAND FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1128
Mailing Address - Country:US
Mailing Address - Phone:830-379-0791
Mailing Address - Fax:830-303-1101
Practice Address - Street 1:1215 E COURT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5129
Practice Address - Country:US
Practice Address - Phone:830-379-0791
Practice Address - Fax:830-303-1101
Is Sole Proprietor?:No
Enumeration Date:2006-02-19
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ98832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85710RMedicare PIN
TX300099411Medicare PIN
G69727Medicare UPIN