Provider Demographics
NPI:1457182073
Name:TENNER, DAVESIA
Entity type:Individual
Prefix:
First Name:DAVESIA
Middle Name:
Last Name:TENNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 SOUTHWEST FWY STE 101
Mailing Address - Street 2:STE 101 # 141261
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4520
Mailing Address - Country:US
Mailing Address - Phone:855-834-6836
Mailing Address - Fax:
Practice Address - Street 1:3120 SOUTHWEST FWY STE 101
Practice Address - Street 2:STE 101 # 141261
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4520
Practice Address - Country:US
Practice Address - Phone:855-834-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy