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General NPI Number Information
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NPI Number | 1306284211
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Entity Type | Individual
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Provider Name | KEVIN SCOTT JENSEN D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 401 E MILAM ST
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City | MEXIA
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State | TX
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Zip | 76667-2329
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Country | US
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Telephone | 254-562-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 401 E MILAM ST
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City | MEXIA
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State | TX
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Zip | 76667-2329
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Country | US
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Telephone | 254-562-2500
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | Q7897
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | Q7897
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License Number State | TX
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