Provider Demographics
NPI:1669617981
Name:HADA-ONDRIEZEK, JENNIFER BROOK (DPM)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:BROOK
Last Name:HADA-ONDRIEZEK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:BROOK
Other - Last Name:HADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:700 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3638
Mailing Address - Country:US
Mailing Address - Phone:432-523-6624
Mailing Address - Fax:432-524-1129
Practice Address - Street 1:700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3638
Practice Address - Country:US
Practice Address - Phone:432-464-2443
Practice Address - Fax:432-464-2563
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002237213ES0103X
OK271213ES0103X
TX1878213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery