Tennison Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

License

E2371 Issued in TX

Legal business name

TENNISON CLINIC

Practice address

445 Roosevelt Dr
Silsbee, TX 77656-3529

Phone

(409) 385-7245

Fax

(409) 385-2494

NPI assigned

Jan 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Douglas K Tennison, MD

Title

Owner

Phone

(409) 385-7245

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1437396934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 ROOSEVELT DR",
            "city": "SILSBEE",
            "state": "TX",
            "postal_code": "776563529",
            "telephone_number": "409-385-7245",
            "fax_number": "409-385-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 ROOSEVELT DR",
            "city": "SILSBEE",
            "state": "TX",
            "postal_code": "776563529",
            "telephone_number": "409-385-7245",
            "fax_number": "409-385-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNISON CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "TENNISON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-385-7245",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "E2371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112046102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF TEXAS",
            "identifier": "0034KY",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112046101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Benay Stegall, M.ED., LPC-A
• Abbie Grace Suggs, COTA
• Brittany Nicole Sundgren
• Superior Home Health Care of Texas
• Swiflee
• Texas Star EMS Corporation
• Lexie D Thomas
• Trans Medic, Inc.
• Melissa Tremont
• Tri-County Home Health, Inc.

• Specialist in Silsbee, TX
• Providers in Silsbee, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.