Organization
JOHNNY LEE HENRY, M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE CASELLA PHYSICIAN ASSISTANT (OFFICE MANAGER)
(214) 631-2653
Entity
Organization
Contact information
Practice address
8200 BROOKRIVER DR, SUITE N-512, DALLAS, TX 75247-4069
(214) 631-2653
(214) 637-9063
Mailing address
8200 BROOKRIVER DR, SUITE N-512, DALLAS, TX 75247-4069
(214) 631-2653
(214) 637-9063
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
E0974
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032327101
—
TX
Enumeration date
07/12/2012
Last updated
07/12/2012
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