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General NPI Number Information
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NPI Number | 1912941659
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Entity Type | Individual
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Provider Name | BRIAN KNOX JENKINS MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 1701 RIVER RUN SUITE 750
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City | FORT WORTH
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State | TX
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Zip | 76107-6579
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Country | US
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Telephone | 817-905-9729
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Fax | 817-378-4756
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Provider Business Mailing Address
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Address Line | PO BOX 100833
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City | FORT WORTH
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State | TX
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Zip | 76185-0833
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Country | US
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Telephone | 817-905-9729
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Fax | 817-378-4756
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M2664
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License Number State | TX
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