Individual
JOHN ABE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
755 N 11TH ST, STE P-3200, BEAUMONT, TX 77702-1501
(409) 899-4111
(409) 899-5670
Mailing address
755 N 11TH ST, STE P-3200, BEAUMONT, TX 77702-1501
(409) 899-4111
(409) 899-5670
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
F9550
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133195101
—
TX
05
—
133195104
—
TX
01
—
HE08643K1
MEDICARE 2ND NUMBER
—
Enumeration date
06/27/2005
Last updated
07/10/2024
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