Penkava, Jeri L
Penkava, Jeri L is an sole proprietor health care provider with primary practice located at 84 Ne Loop 410 Ste 245 , San Antonio TX 78216-5802. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics. Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics is her primary health care specialty. Penkava, Jeri L can be contacted via phone (210) 403-2343.Contact Information
Primary practice address
84 Ne Loop 410 Ste 245
San Antonio TX 78216-5802
Phone: (210) 403-2343
Fax: (210) 403-2350
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | G4242 | Texas |
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | G4242 | Texas |
Profile Details
| NPI number | 1134285430 |
|---|---|
| LBN Legal business name | Penkava, Jeri L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 29th, 2006 |
| Last updated | Aug 18th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134285430 | NPPES |
| Texas | MEDICAID | 121517009 | |
| Texas | Other | 347259 |
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