DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. TOMMY LEE PROVOST

Active Sole Proprietor

MR. TOMMY LEE PROVOST is a Contractor healthcare provider located in GRAND PRAIRIE, Texas. NPI 1396111019 is currently active in the NPPES registry. Verify at CMS.

Contractor · GRAND PRAIRIE, TX

Registration Details

NPI Number
1396111019
Provider Type
Individual
Gender
Male
NPI Issued
Aug 17, 2015 (11.015946285578 yrs)
Last Updated
Aug 17, 2015
Sole Proprietor
Yes

Practice Information

Address
5832 MIDNIGHT LN
GRAND PRAIRIE, TX, 750528585
Browse TX providers · Browse ZIP 75052
Phone
6824655267
Primary Specialty
Contractor
171W00000X

Other Contractor Providers in GRAND PRAIRIE, TX

Name Credential NPI
DWIGHT LEE 1801904644
MRS. SHARON RUTH JACKSON 1134200389
MRS. CLAUDE RUSSELL TROTTER III 1710126230
MARCIE FRAZIER-MARTIN 1073829883
REGINAH MBULA NGWILI 1104308931
SIDDIG IZZELDIN SIDDIG 1851969984
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.