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Individual
TENNILLE L LEFTWICH
Active
Individual
TENNILLE L LEFTWICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
PA05559
TX
363A00000X
Physician Assistant
Primary
PA05559
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174014100
FIRST CARE
TX
05
—
193513201
—
TX
01
—
8Y3719
BCBS
TX
01
—
P00629320
MEDICARE RAIL ROAD
TX
Enumeration date
02/06/2008
Last updated
09/09/2022
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