Provider Demographics
NPI:1174719595
Name:FALKNER, JENNIFER PRESTON (PAC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:PRESTON
Last Name:FALKNER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16902 SOUTHWEST FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3574
Mailing Address - Country:US
Mailing Address - Phone:281-565-9001
Mailing Address - Fax:281-565-2801
Practice Address - Street 1:16902 SOUTHWEST FWY STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-565-9001
Practice Address - Fax:281-565-2801
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05081363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J24NMedicare PIN
TXB88227Medicare UPIN