Individual
TRACY HAMBLIN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 MARY LOU DRIVE, SUITE 100, WILLOW PARK, TX 76087
(817) 930-2030
Mailing address
110 MARY LOU DR STE 100, WILLOW PARK, TX 76087-8767
(817) 930-2030
(817) 757-7333
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
T8117
TX
207RS0010X
Sports Medicine (Internal Medicine) Physician
T8117
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD60450293
WA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
T8117
TX
Other
Enumeration date
04/19/2010
Last updated
01/10/2024
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