Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 35684 | TX |
N | 207RP1001X | Pulmonary Disease | 35684 | TX |
N | 207RS0012X | Sleep Medicine | 35684 | TX |
NPI | 1275604837 |
---|---|
Provider Name | Dr. James H. Henderson II |
First Address | San Antonio, TX 78251-3584 |
Second Address | San Antonio, TX 78251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 12/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2874612-01 | (05) | TX |
2874612-02 | MEDICAID CSHCN (01) | TX |