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General NPI Number Information
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NPI Number | 1487008884
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Entity Type | Organization
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Legal Business Name | OFFICE OF SHERRY KONDZIELA, MD PLLC
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 1307 8TH AVE SUITE 100
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City | FORT WORTH
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State | TX
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Zip | 76104-4137
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Country | US
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Telephone | 817-284-9850
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Fax | 817-921-4406
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Provider Business Mailing Address
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Address Line | 1307 8TH AVE SUITE 100
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City | FORT WORTH
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State | TX
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Zip | 76104-4137
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Country | US
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Telephone | 817-921-4400
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Fax | 817-921-4406
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERRY R KONDZIELA
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Credential | MD
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Telephone | 817-284-9850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | J3520
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License Number State | TX
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