Individual provider Active NPI

Tennyson Murandu, CEO

  • Contractor
  • Denton, TX
National Provider Identifier
1366924508
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
2904 Bareback LN
Denton, TX 76210-0485
Phone
(214) 315-7826
Fax
(214) 343-8554
NPI assigned
Sep 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

2904 Bareback LN
Denton, TX 76210-0485

Mailing address

2904 Bareback LN
Denton, TX 76210-0485
Phone (214) 315-7826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1366924508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 BAREBACK LN",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762100485",
            "telephone_number": "214-315-7826",
            "fax_number": "214-343-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 BAREBACK LN",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762100485",
            "telephone_number": "214-315-7826",
            "fax_number": "214-343-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURANDU",
        "first_name": "TENNYSON",
        "name_prefix": "Mr.",
        "credential": "CEO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.