Provider Demographics
NPI:1679507180
Name:DONNELL-HIGGINS, JENIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:DONNELL-HIGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENIFER
Other - Middle Name:
Other - Last Name:DONNELL KOWALIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1700 COGDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-6162
Mailing Address - Country:US
Mailing Address - Phone:325-573-1300
Mailing Address - Fax:
Practice Address - Street 1:1700 COGDELL BLVD
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-6162
Practice Address - Country:US
Practice Address - Phone:325-573-1300
Practice Address - Fax:806-637-2169
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5514207V00000X, 207VX0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00132901OtherRAILROAD MEDICARE ID
TX092534901Medicaid
TX742965671OtherTAX ID
TXK5514OtherSTATE LICENSE
TX742965671OtherTAX ID
TXK5514OtherSTATE LICENSE