Healthcare Provider Details

I. General information

NPI: 1033026067
Provider Name (Legal Business Name): TRAVIS HENDERSON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9427 PECOS PASS CT
CYPRESS TX
77433-3779
US

IV. Provider business mailing address

9427 PECOS PASS CT
CYPRESS TX
77433-3779
US

V. Phone/Fax

Practice location:
  • Phone: 713-854-7934
  • Fax:
Mailing address:
  • Phone: 713-854-7934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111408
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: