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DR. JEFFREY CRAIG KOMENDA M.D. NPI 1396934865


NPI Information

NPI: 1396934865
Provider Name: DR. JEFFREY CRAIG KOMENDA, M.D.
Classification: Clinic/Center - 261Q00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 45D1064692

Address:
5944 W PARKER RD
100
PLANO, TX
ZIP 75093
Phone: (972) 608-1868
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DR. Jeffrey Craig Komenda, M.D. is a clinic center in Plano, TX with 36 years of experience. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DR. Jeffrey Craig Komenda, M.D. NPI is 1396934865. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1988

The provider's business location address is:

5944 W PARKER RD
100
PLANO, TX
ZIP 75093-421
Phone: (972) 608-1868
Fax: (972) 943-8644

The NPI 1396934865 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 45D1064692 - other - clinical research site with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2007 and was last updated on 2/28/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterH6350TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18C0534MEDICARE PINTEXAS
2165802301OTHERTEXASMEDICAID GROUP
3E21206MEDICARE UPINTEXAS
4124934405MEDICAIDTEXAS
510018514OTHERTEXASAMERIGROUP
6165802302OTHERTEXASMEDICAID TEXAS HEALTH STE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.