Healthcare Provider Details

I. General information

NPI: 1245393156
Provider Name (Legal Business Name): TYRA TENNYSON FRANCIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TYRA DAREECE TENNYSON M.D.

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VALERO WAY
SAN ANTONIO TX
78249-1616
US

IV. Provider business mailing address

3638 ASHLAND CLF
SAN ANTONIO TX
78261-2447
US

V. Phone/Fax

Practice location:
  • Phone: 210-345-4855
  • Fax: 210-345-5630
Mailing address:
  • Phone: 210-260-2798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN1177
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: