Provider Demographics
NPI:1023439320
Name:LENNON, JOHN IV
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:LENNON
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 SHERBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-4926
Mailing Address - Country:US
Mailing Address - Phone:281-798-9772
Mailing Address - Fax:
Practice Address - Street 1:9414 SHERBOURNE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-4926
Practice Address - Country:US
Practice Address - Phone:281-798-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-04
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic