Provider Demographics
NPI:1922240043
Name:TENINTY, KENNETH JAMES (LMT)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:JAMES
Last Name:TENINTY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7226 ECHO RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2729
Mailing Address - Country:US
Mailing Address - Phone:210-693-3971
Mailing Address - Fax:
Practice Address - Street 1:7226 ECHO RIDGE DR
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2729
Practice Address - Country:US
Practice Address - Phone:210-693-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT028742225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist