Healthcare Provider Details

I. General information

NPI: 1598718397
Provider Name (Legal Business Name): JENNIFER M. ZOMNIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER M. BISHOP

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 LEGACY DR BLDG 400
FRISCO TX
75034-6049
US

IV. Provider business mailing address

2840 LEGACY DR BLDG 400
FRISCO TX
75034-6049
US

V. Phone/Fax

Practice location:
  • Phone: 972-712-3652
  • Fax: 214-618-3614
Mailing address:
  • Phone: 972-712-3652
  • Fax: 214-618-3614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM1518
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: