Tom R Fontenot, D.C.
Individual provider Active NPI Radiology Chiropractor · Groves, TX
NPI 1912917337 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1912917337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiology Chiropractor 111NR0200X
- License
- 7909 (TX)
- Practice address
- 5541 E Parkway St
Groves, TX 77619-2935 - Phone
- (409) 960-6300
- Fax
- (409) 960-6363
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5541 E Pkwy
Groves, TX 77619
Phone (409) 960-6300
5541 E Pkwy St
Groves, TX 77619-2935
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040708000422 | TX | Practitioner - Chiropractic | 4880672773 | Practice locations: Groves, TX |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7909 | TX | MD | Radiology Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Chiropractor | 111NR0200X | 7909 | TX | Yes |
Addresses
Primary practice location
5541 E Parkway St
Groves, TX 77619-2935
Mailing address
5541 E Parkway St
Groves, TX 77619-2935
Phone (409) 960-6300
Other providers in Groves, TX
- Tyler Dabel
- David M Garrett, DDS Inc
- Dhmi Corporation
- Elenarc Behavioral Health LLC
- Tara Fenner
- Freedom ER Physicians PLLC
- John W Freeman
- Jathen David Garrett
- George K Katei, M.D., P.a.
- George K. Katei M.D., P.a.
All providers in Groves, TX · Radiology Chiropractor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.