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General NPI Number Information
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NPI Number | 1043052566
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Entity Type | Individual
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Provider Name | KAIRAH JERNAY STRUVE
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Gender | Female
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 201 REGENCY PKWY
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City | MANSFIELD
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State | TX
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Zip | 76063-5638
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Country | US
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Telephone | 682-400-0305
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Fax |
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Provider Business Mailing Address
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Address Line | 711 CAVALIER PL
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City | ARLINGTON
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State | TX
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Zip | 76017-6013
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Country | US
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Telephone | 817-480-6301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | M9X8G9Q2
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License Number State | TX
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