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NPI Code Detail

MEDICARE: MS. ARLENE WYNETTE HENDERSON P.T.

MEDICARE: MS. ARLENE WYNETTE HENDERSON P.T.
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
1225100000XPhysical Therapist1014587TX

General Provider Information

NPI Number : 1942393707
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ARLENE WYNETTE HENDERSON P.T.
Provider Business Mailing Address
First Line : 185 EASTGATE PLZ
Second Line :
City : WACO
State : TX
Zip : 76705-2868
Country : US
Telephone Number : 254-412-2667
Fax Number : 254-799-7568
Provider Business Practice Location Address
First Line : 185 EASTGATE PLZ
Second Line :
City : WACO
State : TX
Zip : 76705-2868
Country : US
Telephone Number : 254-412-2667
Fax Number : 254-799-5768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/21/2008

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