Provider Demographics
NPI:1366924508
Name:MURANDU, TENNYSON (CEO)
Entity type:Individual
Prefix:MR
First Name:TENNYSON
Middle Name:
Last Name:MURANDU
Suffix:
Gender:M
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 BAREBACK LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0485
Mailing Address - Country:US
Mailing Address - Phone:214-315-7826
Mailing Address - Fax:214-343-8554
Practice Address - Street 1:2904 BAREBACK LN
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0485
Practice Address - Country:US
Practice Address - Phone:214-315-7826
Practice Address - Fax:214-343-8554
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor