Provider Demographics
NPI:1841226172
Name:BUCAN KUREPA, JELENA (MD)
Entity type:Individual
Prefix:
First Name:JELENA
Middle Name:
Last Name:BUCAN KUREPA
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 1:4921 LONG PRAIRIE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2782
Mailing Address - Country:US
Mailing Address - Phone:972-691-8700
Mailing Address - Fax:972-691-8782
Practice Address - Street 1:4921 LONG PRAIRIE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2782
Practice Address - Country:US
Practice Address - Phone:972-691-8700
Practice Address - Fax:972-691-8782
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9027207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX039072604Medicaid
TX039072603Medicaid
TX039072603Medicaid
TX039072603Medicaid
TXH15774Medicare UPIN
TX8G4090Medicare ID - Type Unspecified