Provider Demographics
NPI:1912949579
Name:TENCZYNSKI, THEODORE FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:FRANCIS
Last Name:TENCZYNSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 NORTH LOOP W
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1528
Mailing Address - Country:US
Mailing Address - Phone:713-206-3800
Mailing Address - Fax:
Practice Address - Street 1:1631 NORTH LOOP W
Practice Address - Street 2:SUITE 155
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1528
Practice Address - Country:US
Practice Address - Phone:713-802-9000
Practice Address - Fax:713-802-2701
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5962207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098983203Medicaid
TX8P0573OtherBCBS OF TX
1845798OtherAETNA
0004386439OtherAETNA
TX098983201Medicaid
0004386439OtherAETNA
TX098983201Medicaid