Provider Demographics
NPI:1942732334
Name:ESPINAL, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ESPINAL
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 1:11801 SOUTH FWY
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7021
Mailing Address - Country:US
Mailing Address - Phone:817-293-9110
Mailing Address - Fax:817-568-5956
Practice Address - Street 1:11803 SOUTH FWY
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7012
Practice Address - Country:US
Practice Address - Phone:817-293-9110
Practice Address - Fax:817-568-5956
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME145031207R00000X
GA85367207R00000X
FL145031207R00000X
TXS8546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty