Healthcare Provider Details

I. General information

NPI: 1548248719
Provider Name (Legal Business Name): HENDRICK SOUTHWESTERN HEALTH DEVELOPMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 BUFFALO GAP RD STE 2002
ABILENE TX
79606-2756
US

IV. Provider business mailing address

PO BOX 115
ABILENE TX
79604-0115
US

V. Phone/Fax

Practice location:
  • Phone: 325-673-3711
  • Fax: 325-673-4639
Mailing address:
  • Phone: 325-673-3711
  • Fax: 325-673-4639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0036443
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number89476
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number0036443
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0036443
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN BESSENT
Title or Position: AVP
Credential:
Phone: 325-670-6067