Individual
MICHAEL D HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
F4065
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100232103
—
TX
05
—
100232104
—
TX
05
—
139894507
—
TX
01
—
8X1974
BCBS
TX
01
—
P00387545
RAILROAD
TX
Enumeration date
06/03/2006
Last updated
06/11/2018
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