Organization
JOHN M HENDERSON MD FAPA, PLLC
Active
Organization
JOHN M HENDERSON MD FAPA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN M HENDERSON (PROVIDER)
(325) 617-7913
Entity
Organization
Contact information
Practice address
716 S KOENIGHEIM ST, SAN ANGELO, TX 76903-6770
(443) 829-5805
Mailing address
716 S KOENIGHEIM ST, SAN ANGELO, TX 76903-6770
(325) 617-7913
(325) 617-7917
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
D4150
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D4150
TX MEDICAL LICENSE
TX
Enumeration date
10/22/2013
Last updated
03/18/2014
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