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General NPI Number Information
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NPI Number | 1750504379
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Entity Type | Individual
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Provider Name | TANDON JENELL BUNCH RN
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 N ZANG BLVD
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City | DALLAS
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State | TX
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Zip | 75208-4528
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Country | US
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Telephone | 214-948-9950
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Fax | 214-948-2475
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Provider Business Mailing Address
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Address Line | 1821 ESTERS RD APT 2088
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City | IRVING
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State | TX
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Zip | 75061-8007
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Country | US
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Telephone | 214-948-9950
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Fax | 214-948-2475
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 711090
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License Number State | TX
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