Healthcare Provider Details
I. General information
NPI: 1396867511
Provider Name (Legal Business Name): JENNIFER B SYMMANK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/06/2007
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3201 S LOOP 256 STE 200
PALESTINE TX
75801-6913
US
IV. Provider business mailing address
1910 ROSELAND BLVD
TYLER TX
75701-4246
US
V. Phone/Fax
- Phone: 903-723-0330
- Fax: 903-729-6674
- Phone: 903-533-0644
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | M5485 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: