Tina M Fontenot, MS is a
Psychologist based in League City, Texas. Tina M Fontenot is licensed to practice in West Virginia (license number 768) and her current practice location is
1301 Highway 96, League City, Texas. She can be reached at her office (for appointments etc.) via phone at
(281) 724-9792.
NPI number for Tina M Fontenot is 1720186869 and her current mailing address is 1301 Highway 96, League City, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1720186869.
Healthcare Provider's Profile
| Full Name | Tina M Fontenot |
|---|
| Gender | Female |
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| Speciality | Psychologist |
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| Location | 1301 Highway 96, League City, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1720186869
- Provider Enumeration Date: 09/20/2006
- Last Update Date: 09/29/2010
Medical Identifiers
Medical identifiers for Tina M Fontenot such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720186869 | NPI | - | NPPES |
| 9205105000 | Medicaid | WV | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 1182 (West Virginia) | Secondary |
| 103T00000X | Psychologist | 768 (West Virginia) | Primary |
| 101YP2500X | Counselor - Professional | 66102 (Texas) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tina M Fontenot is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tina M Fontenot, MS
1301 Highway 96,
League City, TX 77573-6313
Ph: (281) 724-9792 | Tina M Fontenot, MS
1301 Highway 96,
League City, TX 77573-6313
Ph: (281) 724-9792 |
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