Provider Demographics
NPI:1740875152
Name:FONTENOT, SYMONE HOPE (DC)
Entity type:Individual
Prefix:DR
First Name:SYMONE
Middle Name:HOPE
Last Name:FONTENOT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 BAYOU HOMES DR
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-1338
Mailing Address - Country:US
Mailing Address - Phone:337-277-9528
Mailing Address - Fax:
Practice Address - Street 1:9855 EAGLE DR STE 130
Practice Address - Street 2:
Practice Address - City:MONT BELVIEU
Practice Address - State:TX
Practice Address - Zip Code:77523-7016
Practice Address - Country:US
Practice Address - Phone:281-576-8996
Practice Address - Fax:281-576-7224
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2008111N00000X
TX14711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor