Samuel Pachis Henry, RBT

Primary specialty

Other TechnicianTaxonomy code 247200000X

License

RBT-18-53975

Practice address

12650 N Beach St Ste 146
Fort Worth, TX 76244-4253

Phone

(682) 238-1872

NPI assigned

Feb 13, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1083170138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 DALLAS PKWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 N BEACH ST STE 146",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444253",
            "telephone_number": "682-238-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "SAMUEL",
        "middle_name": "PACHIS",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": "RBT-18-53975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "RBT-18-53975",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Henry, PHARM.D.
• Keshona Henry
• Linda Henry, MD
• Lisa J Henry, LMSW
• Rochelle Amelia Henry, PHD
• Shameeka S Henry, CHW
• Shawn Mark Henry, D.O.
• Zachary Nathaniel Henry
• Jennifer Hensarling, LPC
• Kendi Hensel, DO

• Other Technician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Other Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.