Healthcare Provider Details

I. General information

NPI: 1225759426
Provider Name (Legal Business Name): FELIXVON ISAIAH HENSON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 LA BRANCH ST
HOUSTON TX
77002-8934
US

IV. Provider business mailing address

3101 COLLEGE PARK DR
THE WOODLANDS TX
77384-4099
US

V. Phone/Fax

Practice location:
  • Phone: 713-652-4052
  • Fax: 713-652-5868
Mailing address:
  • Phone: 281-362-0006
  • Fax: 281-362-0233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1353441
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: