Individual
SAMUEL A HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 HOLLYBROOK DR, LONGVIEW, TX 75605-2410
(903) 757-6042
(903) 232-8226
Mailing address
PO BOX 610393, DALLAS, TX 75261-0393
(903) 291-6187
(903) 237-1810
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
P2668
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
206777
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
P2668
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350346803
—
TX
Enumeration date
06/03/2008
Last updated
02/21/2018
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