MEDICARE: SUZANNE HENDERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	24008	TX

General Provider Information

NPI Number	:	1588598437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE HENDERSON

Provider Business Mailing Address
First Line	:	9301 N CENTRAL EXPY STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-0802
Country	:	US
Telephone Number	:	214-558-1492
Fax Number	:

Provider Business Practice Location Address
First Line	:	9301 N CENTRAL EXPY STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-0802
Country	:	US
Telephone Number	:	214-558-1492
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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Directions to “ SUZANNE HENDERSON ” Practice Location

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