Provider Demographics
NPI:1720236888
Name:TEWARI, HENA (MD)
Entity Type:Individual
Prefix:
First Name:HENA
Middle Name:
Last Name:TEWARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-0967
Mailing Address - Fax:806-354-5730
Practice Address - Street 1:6201 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-1786
Practice Address - Country:US
Practice Address - Phone:214-645-0967
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44000207V00000X
TX44726207V00000X
TXQ5108207V00000X
IN01063750A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM86137336Medicaid
IN200919810Medicaid
OK200447070 AMedicaid
TX301087801Medicaid
TX301087802Medicaid
OK200447070 AMedicaid