Individual
DR. MICHAEL GUY TENERIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6204 BALCONES DR, AUSTIN, TX 78731-4214
(512) 302-1771
(512) 302-9774
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
K1694
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125745301
—
TX
05
—
125745302
—
TX
05
—
125745303
—
TX
05
—
125745306
—
TX
05
—
125745307
—
TX
01
—
8R1566
BLUE CROSS OF TEXAS
TX
Enumeration date
06/02/2006
Last updated
07/14/2008
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