| Jenifer Luna Fang, MCN, RDN, LD | |
|
3417 Gaston Ave Ste 965, Dallas, TX 75246-2036 | |
| (972) 817-6050 | |
| Not Available |
| Full Name | Jenifer Luna Fang |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 3 Years |
| Location | 3417 Gaston Ave Ste 965, Dallas, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528711389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 86198088 (Texas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Healthtexas Provider Network | 1355254210 | 1844 |
| Provider Name | Healthtexas Provider Network |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1760488936 PECOS PAC ID: 1355254210 Enrollment ID: O20040727001187 |
| Mailing Address | Practice Location Address |
|---|---|
| Jenifer Luna Fang, MCN, RDN, LD 3417 Gaston Ave Ste 965, Dallas, TX 75246-2036 Ph: (972) 817-6050 | Jenifer Luna Fang, MCN, RDN, LD 3417 Gaston Ave Ste 965, Dallas, TX 75246-2036 Ph: (972) 817-6050 |
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