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General NPI Number Information
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NPI Number | 1366601924
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Entity Type | Individual
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Provider Name | LAURA L TENNER MD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2008
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 7979 WURZBACH RD
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4427
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Country | US
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Telephone | 210-450-2872
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Fax |
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Provider Business Mailing Address
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Address Line | 7703 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3901
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Country | US
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Telephone | 210-450-2872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11014025A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | Q0578
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License Number State | TX
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