MEDICARE: DR. JENNIFER M. ZOMNIR 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
1	207Q00000X	Family Medicine Physician	M1518	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8F8834	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1598718397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER M. ZOMNIR M.D.

Provider Business Mailing Address
First Line	:	2840 LEGACY DR
Second Line	:	BLDG 400
City	:	FRISCO
State	:	TX
Zip	:	75034-6049
Country	:	US
Telephone Number	:	972-712-3652
Fax Number	:	214-618-3614

Provider Business Practice Location Address
First Line	:	2840 LEGACY DR
Second Line	:	BLDG 400
City	:	FRISCO
State	:	TX
Zip	:	75034-6049
Country	:	US
Telephone Number	:	972-712-3652
Fax Number	:	214-618-3614

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	02/25/2010

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