=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689904799
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TENISON WOMEN'S HEALTH CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2010
-----------------------------------------------------
Last Update Date | 06/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5505 BROADWAY BLVD STE B
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75043-3671
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-703-6527
-----------------------------------------------------
Fax | 877-289-8708
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5505 BROADWAY BLVD STE B
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75043-3671
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-703-6527
-----------------------------------------------------
Fax | 214-703-6514
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. SHERRY L TENISON
-----------------------------------------------------
Credential | WHNP
-----------------------------------------------------
Telephone | 214-703-6527
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0005X
-----------------------------------------------------
Taxonomy Name | Ambulatory Family Planning Facility
-----------------------------------------------------
License Number | 558735
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------