Active NPI
Michael D Henderson, MD
- Anesthesiology Physician
- Dallas, TX
National Provider Identifier
1003854969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- F4065
- Practice address
- 6606 LBJ Fwy Ste 200
Dallas, TX 75240 - Phone
- (972) 715-5000
- Fax
- (972) 715-9976
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | F4065 | TX | Primary |
Addresses
Primary practice location
6606 LBJ Fwy Ste 200
Dallas, TX 75240
Mailing address
PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8X1974 | Other | TX | BCBS |
| 100232103 | Medicaid | TX | |
| 100232104 | Medicaid | TX | |
| 139894507 | Medicaid | TX | |
| P00387545 | Other | TX | RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1003854969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 840853",
"city": "DALLAS",
"state": "TX",
"postal_code": "752840853",
"telephone_number": "972-233-1999",
"fax_number": "972-233-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6606 LBJ FWY STE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "75240",
"telephone_number": "972-715-5000",
"fax_number": "972-715-9976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "MICHAEL",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "F4065",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8X1974",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100232103",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100232104",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139894507",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00387545",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.