# GREGORY L HENDERSON MD FACS INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952139347
- **Authorized official:** MR. GREGORY L HENDERSON SR. M.D. (PRESIDENT)
- **Authorized official phone:** (813) 681-1122

## Contact information

- **Practice address:** 3115 W SWANN AVE, TAMPA, FL 33609-4617
- **Practice address phone:** (813) 492-2020
- **Practice address fax:** (813) 492-2099
- **Mailing address:** 403 VONDERBURG DR, BRANDON, FL 33511
- **Mailing address phone:** (813) 681-1122
- **Mailing address fax:** (813) 684-4924

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/25/2024
- **Last updated:** 07/25/2024