Healthcare Provider Details

I. General information

NPI: 1235557554
Provider Name (Legal Business Name): JENNIFER D PENLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14340 MEMORIAL DR STE 100
HOUSTON TX
77079-1835
US

IV. Provider business mailing address

14340 MEMORIAL DR STE 100
HOUSTON TX
77079-1835
US

V. Phone/Fax

Practice location:
  • Phone: 832-680-2074
  • Fax:
Mailing address:
  • Phone: 832-680-2074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberS1485
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: