Theodric Blue Hendrix Jr., M.D.

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

A29978 Issued in CA

Practice address

450 N Roxbury Dr
Suite 500
Beverly Hills, CA 90210-4231

Phone

(310) 652-3570

Fax

(310) 388-0157

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1528138294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N ROXBURY DR",
            "address_2": "SUITE 500",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104231",
            "telephone_number": "310-652-3570",
            "fax_number": "310-388-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N ROXBURY DR",
            "address_2": "SUITE 500",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104231",
            "telephone_number": "310-652-3570",
            "fax_number": "310-388-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "THEODRIC",
        "middle_name": "BLUE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A29978",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "A29978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "00A299780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Barnett Heller
• Lindsay Heller, PSY.D.
• Lisa R Heller
• Sheridan Katherine Henderson, LMFT
• Toni La'Nette Henderson, D.D.S.
• Henrietta Stancz-Szeder MD Inc
• Rebecca Karin Henson
• Her Healing Community
• Jessica Heravi, PHYSICIAN ASSISTANT
• Herbert a Glicksman

• Obstetrics Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Obstetrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.