Individual
JOHN C HERNDON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12222 MERIT DR STE 600, DALLAS, TX 75284-6533
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0865
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H4399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120424006
—
TX
05
—
120424008
—
TX
05
—
120424009
—
TX
05
—
120424010
—
TX
05
—
120424011
—
TX
01
—
8BJ007
BCBS
TX
01
—
P00754972
RAILROAD
TX
Enumeration date
06/02/2005
Last updated
07/13/2022
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