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General NPI Number Information
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NPI Number | 1922482736
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Entity Type | Organization
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Legal Business Name | JILL CAROLE KRANZOW DPM PA
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 8080 STATE HIGHWAY 121 SUITE 200
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City | MCKINNEY
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State | TX
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Zip | 75070-2900
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Country | US
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Telephone | 972-769-7280
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Fax | 972-769-7287
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Provider Business Mailing Address
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Address Line | 6309 PRESTON RD STE 1200
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City | PLANO
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State | TX
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Zip | 75024-2741
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Country | US
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Telephone | 972-769-7280
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Fax | 972-769-7287
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Authorized Official
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Title or Position | OWNER
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Name | JILL C. WISDOM
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Credential | DPM
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Telephone | 972-769-7280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 1283
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License Number State | TX
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