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NPI Code Detail

MEDICARE: DR. JENNIFER TENGRA D.C.

MEDICARE: DR. JENNIFER TENGRA D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor12023TX

General Provider Information

NPI Number : 1922368463
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER TENGRA D.C.
Provider Business Mailing Address
First Line : 4634 CAMP BOWIE BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-3744
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4634 CAMP BOWIE BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-3744
Country : US
Telephone Number : 817-735-3828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2012
Last Update Date : 05/17/2012

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Directions to “ DR. JENNIFER TENGRA D.C.” Practice Location

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