Provider Demographics
NPI:1699824706
Name:CARDWELL, JENNIFER MILLS (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MILLS
Last Name:CARDWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6034 W COURTYARD DR STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-5064
Mailing Address - Country:US
Mailing Address - Phone:512-336-2777
Mailing Address - Fax:512-336-2778
Practice Address - Street 1:345 CYPRESS CREEK RD STE 104
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4484
Practice Address - Country:US
Practice Address - Phone:512-336-2777
Practice Address - Fax:512-336-2778
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL2170208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H44513Medicare UPIN