Individual
DR. ROGER CHAD HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
405 LONDONDERRY DR, SUITE 105, WACO, TX 76712-7924
(254) 776-0266
Mailing address
405 LONDONDERRY DR, STE 105, WACO, TX 76712-7920
(254) 776-0266
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
BP1-0026252
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3849179302
MYUTMB 3849179302-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
06/13/2018
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