Provider Demographics
NPI:1578693198
Name:KREJCI-MANWARING, JENNIFER (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:KREJCI-MANWARING
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 1:7400 MERTON MINTER ST # 1A
Mailing Address - Street 2:AUDIE MURPHY VETERANS HOSPITAL
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:210-949-9248
Mailing Address - Fax:210-949-3107
Practice Address - Street 1:7400 MERTON MINTER ST # 1A
Practice Address - Street 2:AUDIE MURPHY VETERANS HOSPITAL
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-949-9248
Practice Address - Fax:210-949-3107
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0185207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195506403Medicaid
TX195506403Medicaid