Individual provider Active NPI

Travis Scott Henry, M.D.

  • Pediatrics Physician
  • Waxahachie, TX
National Provider Identifier
1093743569
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L0819 Issued in TX
Practice address
505 N Highway 77
Suite 200
Waxahachie, TX 75165-1128
Phone
(972) 923-1686
Fax
(972) 937-7731
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L0819 TX Primary

Addresses

Primary practice location

505 N Highway 77
Suite 200
Waxahachie, TX 75165-1128

Mailing address

505 N Highway 77
Suite 200
Waxahachie, TX 75165-1128
Phone (972) 923-1686

Other identifiers 6

IdentifierTypeStateIssuer
0370751-02MedicaidTX
8BR077OtherTXBCBS
0370751-01MedicaidTX
037075103MedicaidTX
81834SOtherTXBCBS
8V7015OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061102000530 TX Practitioner - Pediatric Medicine 9133126238 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31946TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Apr 1, 2019 Accepting new patients
Healthtexas Provider Network Pediatrics Current Accepting new patients
Healthtexas Provider Network CurrentSince Apr 1, 2019 Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

1441 S Midlothian Pkwy
Ste 100A
Midlothian, TX 76065
Phone (469) 800-9440

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

2460 N Interstate Highway 35 E
Ste 100
Waxahachie, TX 75165
Phone (469) 800-9500

505 N Highway 77
Ste 200
Waxahachie, TX 75165
Phone (972) 923-1686

Interoperability endpoints

  • Direct secure messaging: thenry226398@direct.sw.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247097600000",
    "number": "1093743569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N HIGHWAY 77",
            "address_2": "SUITE 200",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651128",
            "telephone_number": "972-923-1686",
            "fax_number": "972-937-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N HIGHWAY 77",
            "address_2": "SUITE 200",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651128",
            "telephone_number": "972-923-1686",
            "fax_number": "972-937-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "TRAVIS",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2009-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L0819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0370751-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BR077",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0370751-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037075103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "81834S",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8V7015",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

Verify at the official NPI Registry.