Provider Demographics
NPI:1669893848
Name:TENNEY, ERIN (PA-C, MPAS)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:TENNEY
Suffix:
Gender:F
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 WALNUT HILL LN STE 610
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3815
Mailing Address - Country:US
Mailing Address - Phone:214-345-6000
Mailing Address - Fax:214-345-6026
Practice Address - Street 1:8440 WALNUT HILL LN STE 610
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3815
Practice Address - Country:US
Practice Address - Phone:214-345-6000
Practice Address - Fax:214-345-6026
Is Sole Proprietor?:No
Enumeration Date:2013-12-14
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057536363A00000X
TXPA08831363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant