Individual
CARTER HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 CLINIC DR, TYLER, TX 75701-2120
(903) 592-8115
Mailing address
1301 CLINIC DR, TYLER, TX 75701-2120
(903) 592-8115
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
40425
TX
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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