Provider Demographics
NPI:1902875453
Name:ARANDA, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ARANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1510 W 34TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-1400
Mailing Address - Country:US
Mailing Address - Phone:512-533-9900
Mailing Address - Fax:512-533-9901
Practice Address - Street 1:1510 W 34TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1400
Practice Address - Country:US
Practice Address - Phone:512-533-9900
Practice Address - Fax:512-533-9901
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL6768207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB117661Medicare PIN