Wallace Henry Jr.

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Practice address

1055 S Stapley Dr
Mesa, AZ 85204

Phone

(480) 833-9100

NPI assigned

Nov 23, 2015

Last updated

Nov 23, 2015By the provider in NPPES

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

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": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1316311715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 S STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045013",
            "telephone_number": "480-833-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 S STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85204",
            "telephone_number": "480-833-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "WALLACE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camilla Henry, RDN
• Carmen Lynn Henry, FNP
• Lacey Henry
• Paula Henry, COTA
• Susan Jean Henry, BS, CLINICIAN I
• Caroline Anne Hensley, BSN, RN
• Blake Henson, OD
• Nicole Henson
• Tasha Henstein, RPH
• Sheri F. Hentz, OT

• Surgical Technologist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Surgical Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.