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General NPI Number Information
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NPI Number | 1073714697
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Entity Type | Organization
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Legal Business Name | PATRICK B. HENDERSON
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 500 E ARAPAHO RD 313
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City | RICHARDSON
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State | TX
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Zip | 75081-2765
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Country | US
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Telephone | 972-235-4200
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Fax | 972-235-2300
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Provider Business Mailing Address
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Address Line | 500 E ARAPAHO RD 313
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City | RICHARDSON
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State | TX
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Zip | 75081-2765
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Country | US
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Telephone | 972-235-4200
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Fax | 972-235-2300
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Authorized Official
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Title or Position | OWNER
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Name | MR. PATRICK BOUVIER HENDESON
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Credential |
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Telephone | 972-235-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 0090326
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 0090326
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0090326
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License Number State | TX
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