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General NPI Number Information
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NPI Number | 1104817022
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Entity Type | Individual
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Provider Name | RICHARD G HENSLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 111 DALLAS ST
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City | SAN ANTONIO
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State | TX
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Zip | 78205-1201
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Country | US
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Telephone | 512-579-4000
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Fax | 512-439-2814
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Provider Business Mailing Address
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Address Line | 3445 EXECUTIVE CENTER DR STE 250
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City | AUSTIN
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State | TX
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Zip | 78731-1678
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Country | US
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Telephone | 512-579-4000
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Fax | 512-439-2814
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | J4201
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License Number State | TX
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