Healthcare Provider Details

I. General information

NPI: 1225567696
Provider Name (Legal Business Name): DR. JULIAN HENDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17833 KUYKENDAHL RD
SPRING TX
77379-8112
US

IV. Provider business mailing address

9310 SAN MARCO DR
MISSOURI CITY TX
77459-7376
US

V. Phone/Fax

Practice location:
  • Phone: 832-559-7808
  • Fax:
Mailing address:
  • Phone: 317-965-7887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number97496
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59097
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: