Individual
DR. AMY ELIZABETH HENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4102 24TH ST STE 506, LUBBOCK, TX 79410-1805
(806) 725-7980
(806) 723-7985
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0102201628
VA
207XP3100X
Pediatric Orthopaedic Surgery Physician
0102201628
VA
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
R0412
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367943301
—
TX
01
—
557830YKT8
TX MEDICARE
TX
01
—
8GK818
BCBS TX
TX
Enumeration date
01/28/2006
Last updated
10/24/2017
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