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General NPI Number Information
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NPI Number | 1679563969
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Entity Type | Individual
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Provider Name | TIMOTHY D HENDERSON D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 1019 E CALIFORNIA ST
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City | GAINESVILLE
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State | TX
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Zip | 76240-4203
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Country | US
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Telephone | 940-902-3979
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Fax | 214-292-9650
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Provider Business Mailing Address
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Address Line | PO BOX 1163
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City | GAINESVILLE
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State | TX
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Zip | 76241-1163
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Country | US
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Telephone | 940-902-3979
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Fax | 214-292-9650
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 8356
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License Number State | TX
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