Provider Demographics
NPI:1053622787
Name:JENNIFER ALDRICH, MD, PA
Entity type:Organization
Organization Name:JENNIFER ALDRICH, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-797-2712
Mailing Address - Street 1:8335 WALNUT HILL LN STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4256
Mailing Address - Country:US
Mailing Address - Phone:214-382-5810
Mailing Address - Fax:855-479-1759
Practice Address - Street 1:8335 WALNUT HILL LN STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4256
Practice Address - Country:US
Practice Address - Phone:214-382-5810
Practice Address - Fax:214-382-5816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty