Provider Demographics
NPI:1770044182
Name:LA, JENNIFER HANH (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HANH
Last Name:LA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2922 MORGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-2141
Mailing Address - Country:US
Mailing Address - Phone:361-887-6601
Mailing Address - Fax:361-887-8225
Practice Address - Street 1:2922 MORGAN AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-2141
Practice Address - Country:US
Practice Address - Phone:361-887-6601
Practice Address - Fax:361-887-8225
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT3810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine