Basic Information
| Provider Information | |||||||||
| NPI: | 1720236888 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TEWARI | ||||||||
| FirstName: | HENA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 845347 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752845347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146450967 | ||||||||
| FaxNumber: | 8063545730 | ||||||||
| Practice Location | |||||||||
| Address1: | 6201 HARRY HINES BLVD | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753901786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146450967 | ||||||||
| FaxNumber: | 2146450078 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2008 | ||||||||
| LastUpdateDate: | 03/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 44000 | TX | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 44726 | TX | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | Q5108 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 01063750A | IN | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 86137336 | 05 | NM | MEDICAID | 200919810 | 05 | IN | MEDICAID | 200447070 A | 05 | OK | MEDICAID | 301087801 | 05 | TX | MEDICAID | 301087802 | 05 | TX | MEDICAID |