Individual
SAMUEL WYATT HENSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
100 CIRRUS CV, CIBOLO, TX 78108
(210) 596-6938
Mailing address
100 CIRRUS CV, CIBOLO, TX 78108-4250
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
08/21/2017
Last updated
08/21/2017
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