MEDICARE: DR. DONALD A KENNERLY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician	G6190	TX
2	207R00000X	Internal Medicine Physician	G6190	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81941G	OTHER	TX	BC/BS

General Provider Information

NPI Number	:	1538124763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD A KENNERLY MD

Provider Business Mailing Address
First Line	:	8080 N CENTRAL EXPY
Second Line	:	SUITE 1650
City	:	DALLAS
State	:	TX
Zip	:	75206-1838
Country	:	US
Telephone Number	:	972-860-8648
Fax Number	:

Provider Business Practice Location Address
First Line	:	4004 WORTH ST
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75246-1600
Country	:	US
Telephone Number	:	214-820-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	09/11/2025

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Directions to “ DR. DONALD A KENNERLY MD” Practice Location

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