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NPI Code Detail

MEDICARE: HENDERSON MEMORIAL CLINIC

MEDICARE: HENDERSON MEMORIAL CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2208600000XSurgery Physician
3207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1598719619
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENDERSON MEMORIAL CLINIC
Provider Business Mailing Address
First Line : 300 WILSON ST
Second Line :
City : HENDERSON
State : TX
Zip : 75652-5956
Country : US
Telephone Number : 903-657-7541
Fax Number : 903-657-4009
Provider Business Practice Location Address
First Line : 300 WILSON ST
Second Line :
City : HENDERSON
State : TX
Zip : 75652-5956
Country : US
Telephone Number : 903-657-7541
Fax Number : 903-657-4009
Authorized Official
Title or Position : CEO
Name : MR. MARK LEITNER
Credential :
Telephone Number : 903-655-3616
Provider Enumeration Date : 05/22/2006
Last Update Date : 09/05/2008

Similar Medicare Providers

1629071527 — DR. MARK A HACKBARTH MD
Practice Location Address:
300 WILSON ST
HENDERSON, TX
75652-5956
Practice Phone: 903-655-6536
Practice Fax:
1770582736 — MR. DWIGHT M HALL CRNA
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1932174596 — JATHAN CANTU M.D.
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1477512820 — DR. GORDON URETSKY MD
Practice Location Address:
300 WILSON ST
HENDERSON, TX
75652-5956
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1205880424 — HENDERSON MEMORIAL HOSPITAL
Practice Location Address:
300 WILSON ST
HENDERSON, TX
75652-5956
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Practice Fax:
1134167984 — HENDERSON MEMORIAL HOSPITAL
Practice Location Address:
300 WILSON ST
HENDERSON, TX
75652-5956
Practice Phone: 903-675-7541
Practice Fax:

Directions to “HENDERSON MEMORIAL CLINIC ” Practice Location

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