Diana H Henderson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

H6284 Issued in TX

Practice address

4775 Hamilton Wolfe Rd Ste 1
San Antonio, TX 78229-3456

Phone

(210) 616-0283

Fax

(210) 616-0071

NPI assigned

Aug 3, 2005

Sex

Female

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388102400000",
    "number": "1083615884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 HAMILTON WOLFE RD STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293456",
            "telephone_number": "210-616-0283",
            "fax_number": "210-616-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 HAMILTON WOLFE RD STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293456",
            "telephone_number": "210-616-0283",
            "fax_number": "210-616-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DIANA",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2013-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "H6284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133549901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brogan Shea Henderson, LPC
• Caitlin Henderson
• Charles Henderson, LMSW-AP
• Clinton Lance Henderson, MD
• Cody L Henderson, M.D.
• Elizabeth Henderson
• Jacquelyn Henderson
• James H. Henderson II, M.D.
• Kati Renee Henderson
• Kim Elaine Moore Henderson, CCC - SLP

• Otolaryngology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; 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.