Provider Demographics
NPI:1184466641
Name:BENNETT, TEVONTE SHEMAR
Entity type:Individual
Prefix:MR
First Name:TEVONTE
Middle Name:SHEMAR
Last Name:BENNETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6336 WOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-1750
Mailing Address - Country:US
Mailing Address - Phone:713-533-8319
Mailing Address - Fax:
Practice Address - Street 1:6336 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1750
Practice Address - Country:US
Practice Address - Phone:713-533-8319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist