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NPI Code Detail

MEDICARE: ELENA AMMATUNA KENNEDY M.D.

MEDICARE: ELENA AMMATUNA KENNEDY M.D.
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
12084P0800XPsychiatry PhysicianP8782TX
2390200000XStudent in an Organized Health Care Education/Training ProgramBP10038391TX

General Provider Information

NPI Number : 1548576127
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELENA AMMATUNA KENNEDY M.D.
Provider Business Mailing Address
First Line : 1820 PRESTON PARK BLVD STE 2200
Second Line :
City : PLANO
State : TX
Zip : 75093-3614
Country : US
Telephone Number : 214-495-1942
Fax Number :
Provider Business Practice Location Address
First Line : 1820 PRESTON PARK BLVD STE 2200
Second Line :
City : PLANO
State : TX
Zip : 75093-3614
Country : US
Telephone Number : 214-495-1942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2010
Last Update Date : 08/19/2025

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