Healthcare Provider Details

I. General information

NPI: 1932138856
Provider Name (Legal Business Name): KENDRA A RORRIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4716 ALLIANCE BLVD SUITE 750
PLANO TX
75093-5371
US

IV. Provider business mailing address

4716 ALLIANCE BLVD SUITE 750
PLANO TX
75093-5371
US

V. Phone/Fax

Practice location:
  • Phone: 469-800-6000
  • Fax: 469-800-6001
Mailing address:
  • Phone: 469-800-6034
  • Fax: 469-800-6039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberL6608
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: