William Bradley Henderson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA08230 Issued in TX

Practice address

1651 W Rosedale St Ste 100
Fort Worth, TX 76104-7437

Phone

(817) 930-2030

NPI assigned

Jan 4, 2013

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: williambrad.henderson.p1@direct.thc.nextgenshare.com

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.

• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment Care Compare group
• Michael H Boothby, MD PA

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
  • NPI 1871878876
  Medicare reassignment
• Texas Health Care, P.L.L.C.

  • Otolaryngology Physician
  • Fort Worth, TX
  • NPI 1245686617
  NPD
• Texas Health Care, P.L.L.C.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1821026352
  NPD

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1225375736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 W ROSEDALE ST STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047437",
            "telephone_number": "817-930-2030",
            "fax_number": "817-930-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 W ROSEDALE ST STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047437",
            "telephone_number": "817-930-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "WILLIAM",
        "middle_name": "BRADLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-04",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA08230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "315256301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Sue Henderson, L.P.T.
• Ryan Alisa Henderson
• Scharlyn R Henderson, LCSW
• Trudie Henderson, WHNP
• William B Henderson, ANP
• Allison Michelle Hendon, DO
• Jordan Hendon
• George David Hendricks Jr., M.D.
• Gabriela Garcia Hendrickson
• Danielle Eager Hendrix, M.S., CCC-SLP

• Surgical Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.