JOHN M HENDERSON MD FAPA, PLLC (NPI# 1164850657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164850657 |
| Entity Type | Organization |
| Organization Name | JOHN M HENDERSON MD FAPA, PLLC |
| Practice Address |
716 S Koenigheim St San Angelo TX 76903-6770 |
| Practice Telephone | 4438295805 |
| Mailing Telephone | 3256177913 |
| Mailing Fax Number | 3256177917 |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2014-03-18 |
| Authorized Official Name | DR. JOHN M HENDERSON (PROVIDER) |
| Authorized Official Telephone | 3256177913 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | D4150 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TX MEDICAL LICENSE | D4150 | 01 |
| Street Address |
716 S KOENIGHEIM ST |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76903-6770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306386081 | The Waterford Wellness Spa | Clinic/Center | 602 S. Abe, San Angelo, TX 76903 | 2017-03-01 |
| 1154782415 | Jerrica Elayne Escobedo | Counselor | 424 South Oakes, San Angelo, TX 76903 | 2016-03-15 |
| 1578923868 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3440 S. Bryant Blvd, San Angelo, TX 76903 | 2016-02-29 |
| 1821475161 | San Angelo Dental, Pllc | Dentist | 614 29th Street, Suite, Sanangelo, TX 76903 | 2015-05-06 |
| 1033549670 | Tina Faye Luck | Nurse Practitioner | 36 E Twohig Ave Ste 1100, San Angelo, TX 76903 | 2013-11-18 |
| 1295087294 | Tara Joiner | Counselor | 27 W Beauregard Ave, San Angelo, TX 76903 | 2012-10-15 |
| 1225380728 | Tanya L Favor | Physician Assistant | 215 E. College, San Angelo, TX 76903 | 2012-10-08 |
| 1336459551 | Education Service Center | Social Worker | 612 S Irene, San Angelo, TX 76903 | 2010-10-21 |
| 1508194176 | Pay and Save Inc | Pharmacy | 1926 N. Bryant Blvd., San Angelo, TX 76903 | 2009-11-19 |
| 1326375734 | Pay and Save Inc | Pharmacy | 2 S. Main St., San Angelo, TX 76903 | 2009-11-05 |
| Find all providers in zip 76903 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598375487 | Tara Austin | Clinical Neuropsychologist | 4900 Bagby Ave Apt 819, Waco, TX 76711-0035 | 2020-08-05 |
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1992330864 | Annelizabeth Robinson Carlew | Clinical Neuropsychologist | 6333 Forest Park Rd 1st Fl Bla.100, Dallas, TX 75390-5461 | 2020-03-11 |
| 1710511753 | Gulf Coast Neuropsychology, Pllc | Clinical Neuropsychologist | 1110 Nasa Pkwy Ste 108c, Houston, TX 77058-3351 | 2020-02-28 |
| 1356988372 | Jennifer Reynolds | Clinical Neuropsychologist | 8005 Canyon Parke Ct, Austin, TX 78726-4029 | 2019-12-09 |
| 1649835216 | Kaleidoscope Counseling and Assessment | Clinical Neuropsychologist | 1705 S Capital of Texas Hwy Ste 130, Austin, TX 78746-6587 | 2019-05-08 |
| 1104392067 | Neuropsychological Services of Texarkana Pllc | Clinical Neuropsychologist | 5411 Plaza Dr Ste E, Texarkana, TX 75503-1667 | 2018-10-18 |
| 1801370184 | Professional Exam Services Inc. | Clinical Neuropsychologist | 2233 E Grauwyler Rd Ste 107, Irving, TX 75061-3239 | 2018-09-21 |
| 1255815072 | Seema Pandya | Clinical Neuropsychologist | 9101 N Central Expy Ste 230, Dallas, TX 75231-6079 | 2018-09-18 |
| 1972097145 | Juliette Galindo | Clinical Neuropsychologist | 1333 Moursund Ave, Psychology/neuropsychology H124, Houston, TX 77030-3405 | 2018-06-20 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANGELO |
| Zip Code | 76903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.