Individual
MICHAEL TODD HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
45 NE LOOP 410, SUITE 900, SAN ANTONIO, TX 78216-5832
(210) 375-7790
(210) 979-9686
Mailing address
1229 MADISON ST STE 1440, SEATTLE, WA 98104-3538
(206) 625-0578
(206) 625-9184
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OP60774008
WA
207L00000X
Anesthesiology Physician
P7645
TX
390200000X
Student in an Organized Health Care Education/Training Program
2009015671
MO
Other
Enumeration date
06/24/2009
Last updated
10/04/2017
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