Provider Demographics
NPI:1285960500
Name:CROOK, TENA MEASLES (LMT)
Entity type:Individual
Prefix:
First Name:TENA
Middle Name:MEASLES
Last Name:CROOK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 E MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MADISONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77864-2126
Mailing Address - Country:US
Mailing Address - Phone:979-218-1016
Mailing Address - Fax:
Practice Address - Street 1:1520 E MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MADISONVILLE
Practice Address - State:TX
Practice Address - Zip Code:77864-2126
Practice Address - Country:US
Practice Address - Phone:979-218-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT041930225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist