Organization
DENTON PEDIATRIC PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF HENDERSON (PRESIDENT)
(972) 401-8720
Entity
Organization
Contact information
Practice address
3537 S I-35 E, SUITE 207, DENTON, TX 76210-6800
(940) 565-1222
(940) 565-1220
Mailing address
3537 S I-35 E, SUITE 207, DENTON, TX 76210-6800
(940) 565-1222
(940) 565-1220
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003RH
BLUE CROSS BLUE SHIELD
TX
05
—
194449801
—
TX
Enumeration date
04/01/2008
Last updated
10/15/2008
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