| Randall D Henderson Do Pa | |
|
202 E Jefferson Ave Whitney TX 76692-2398 | |
| (254) 694-2221 | |
| (254) 694-9978 |
| Full Name | Randall D Henderson Do Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 202 E Jefferson Ave, Whitney, Texas |
| Authorized Official Name and Position | Linda J Hall (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 2546942221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randall D Henderson Do Pa 202 E Jefferson Ave Whitney TX 76692-2398 Ph: (254) 694-2221 | Randall D Henderson Do Pa 202 E Jefferson Ave Whitney TX 76692-2398 Ph: (254) 694-2221 |
| NPI Number | 1871779090 |
|---|---|
| Provider Enumeration Date | 01/17/2008 |
| Last Update Date | 06/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871779090 | NPI | - | NPPES |
| 00925U | Other | TX | BCBS GROUP |
| 159120801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L1340 (Texas) | Primary |
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