Provider Demographics
NPI:1811376007
Name:LANE, JENNA K (MD)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:K
Last Name:LANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W LOUIS HENNA BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-1203
Mailing Address - Country:US
Mailing Address - Phone:512-244-4272
Mailing Address - Fax:
Practice Address - Street 1:1901 MEDI PARK DR STE 2
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2105
Practice Address - Country:US
Practice Address - Phone:806-350-7918
Practice Address - Fax:806-418-8982
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT5604207L00000X, 208VP0014X
MS27314207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology