Active NPI
Matthew David Henderson, PHARMD
- Pharmacist
- Farmers Branch, TX
National Provider Identifier
1629351895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18071
- Practice address
- 2270 Springlake Rd Ste 800
Farmers Branch, TX 75234-5852 - Phone
- (518) 369-8133
- Fax
- (888) 362-9587
- NPI assigned
- Sep 23, 2011
- Last updated
- Aug 9, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 67935 | TX | |
| Pharmacist | 183500000X | 18071 | NV | Primary |
Addresses
Primary practice location
2270 Springlake Rd Ste 800
Farmers Branch, TX 75234-5852
Mailing address
3405 Veronica Dr
Flower Mound, TX 75022-0974
Phone (518) 369-8133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67935 | TX | MD | Clinical Social Worker |
| 18071 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660003200000",
"number": "1629351895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3405 VERONICA DR",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750220974",
"telephone_number": "518-369-8133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2270 SPRINGLAKE RD STE 800",
"city": "FARMERS BRANCH",
"state": "TX",
"postal_code": "752345852",
"telephone_number": "518-369-8133",
"fax_number": "888-362-9587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-23",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "67935",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "18071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmers Branch, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.