Provider Demographics
NPI:1548454226
Name:KENDALL M. JONES MD PA
Entity type:Organization
Organization Name:KENDALL M. JONES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-312-9944
Mailing Address - Street 1:PO BOX 797307
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-7307
Mailing Address - Country:US
Mailing Address - Phone:972-312-9944
Mailing Address - Fax:
Practice Address - Street 1:3060 COMMUNICATIONS PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8449
Practice Address - Country:US
Practice Address - Phone:972-312-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ26222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E45424Medicare UPIN