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Organization
RANDALL D HENDERSON DO PA
Active
Organization
RANDALL D HENDERSON DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA J HALL (BUSINESS OFFICE MANAGER)
(254) 694-2221
Entity
Organization
Contact information
Practice address
202 E JEFFERSON AVE, WHITNEY, TX 76692-2398
(254) 694-2221
(254) 694-9978
Mailing address
202 E JEFFERSON AVE, WHITNEY, TX 76692-2398
(254) 694-2221
(254) 694-9978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L1340
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00925U
BCBS GROUP
TX
05
—
159120801
—
TX
Enumeration date
01/17/2008
Last updated
06/09/2011
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