Individual
ALLEN T TENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-4522
(903) 531-4522
Mailing address
714 TURTLE CREEK DR, TYLER, TX 75701-1833
(903) 595-4333
(903) 535-9845
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
451001
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80115H
BCBS
TX
Enumeration date
03/07/2006
Last updated
11/21/2007
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