Individual
AMY SUZANNE HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1517 TEXAS DR, WEATHERFORD, TX 76086-6327
(817) 458-3300
(817) 458-3370
Mailing address
1517 TEXAS DR, WEATHERFORD, TX 76086-6327
(817) 458-3300
(817) 458-3370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04161
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198927901
—
TX
05
—
198927903
—
TX
01
—
8Y9488
BCBS
TX
01
—
P00815324
RAILROAD MEDICARE
TX
Enumeration date
11/21/2008
Last updated
07/12/2021
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