Provider Demographics
NPI:1336655497
Name:HENDERSON, TENESSA TENAE
Entity Type:Individual
Prefix:MS
First Name:TENESSA
Middle Name:TENAE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 STONES THROW AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-0330
Mailing Address - Country:US
Mailing Address - Phone:832-503-6300
Mailing Address - Fax:
Practice Address - Street 1:346 STONES THROW AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-0330
Practice Address - Country:US
Practice Address - Phone:832-503-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care