Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | E8548 | TX |
NPI | 1245232487 |
---|---|
Provider Name | Dr. Anthony Robert Henry |
First Address | Round Rock, TX 78664-2166 |
Second Address | Round Rock, TX 78664-2166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 13/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
198147401 | (05) | TX |
1981474-02 | (05) | TX |
F27956 | (02) |