Individual
MR. CULLEN F. TENNISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3305 NORTHLAND DR, STE 310, AUSTIN, TX 78731
(512) 275-0282
(512) 275-0281
Mailing address
3305 NORTHLAND DR, STE 310, AUSTIN, TX 78731
(512) 275-0282
(512) 275-0281
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1130250
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86367T
BLUE CROSS BLUE SHEILD
TX
Enumeration date
08/15/2006
Last updated
12/05/2008
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