Individual
THOMAS THOMAN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3410 FAR WEST BLVD, SUITE 140, AUSTIN, TX 78731-3194
(512) 427-1100
(512) 427-1208
Mailing address
3410 FAR WEST BLVD, SUITE 140, AUSTIN, TX 78731-3194
(512) 427-1100
(512) 427-1208
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
F4863
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115509501
—
TX
01
—
180008032
MEDICARE RAILROAD
TX
Enumeration date
10/16/2007
Last updated
03/28/2012
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