Cody D Henson, | |
5410 Maryland Way Ste 300, Brentwood, TN 37027-5339 | |
(615) 371-4423 | |
Not Available |
Full Name | Cody D Henson |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 5410 Maryland Way Ste 300, Brentwood, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992496889 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 899553 (Texas) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 1135944 (Texas) | Primary |
Entity Name | Sound Physicians Anesthesiology Of Texas Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295356277 PECOS PAC ID: 1254751407 Enrollment ID: O20201009000612 |
Mailing Address | Practice Location Address |
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Cody D Henson, 8308 High Garden St, Fort Worth, TX 76123-4202 Ph: (903) 805-1030 | Cody D Henson, 5410 Maryland Way Ste 300, Brentwood, TN 37027-5339 Ph: (615) 371-4423 |
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