Individual
ERNESTO ANTONIO PENA-TEJEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1068 CRESTHAVEN RD STE 500, MEMPHIS, TN 38119-0846
(901) 866-8525
Mailing address
1068 CRESTHAVEN RD STE 300, MEMPHIS, TN 38119-0809
(901) 866-8864
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
338914
LA
363A00000X
Physician Assistant
5999
TN
363AS0400X
Surgical Physician Assistant
Primary
5999
TN
Other
Enumeration date
10/06/2023
Last updated
03/13/2025
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