Individual provider Active NPI

Floyd Arthur Hennan, D.O.

  • Family Medicine Physician
  • Decatur, TX
National Provider Identifier
1689663403
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K9563 Issued in TX
Practice address
134 High Ridge CT
Decatur, TX 76234-1775
Phone
(325) 829-2125
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K9563 TX Primary

Addresses

Primary practice location

134 High Ridge CT
Decatur, TX 76234-1775

Mailing address

200 E Livingston St
San Augustine, TX 75972-2028
Phone (936) 275-9910

Other identifiers 3

IdentifierTypeStateIssuer
036724504MedicaidTX
036724502MedicaidTX
036724506MedicaidTX

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
I20260113002511 TX Order and Referring Only - Family PracticePractitioner - Family Practice 6204721194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3976AZMDPsychologist
K9563TXMDFamily Medicine Physician
E1966ARMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group West Texas, PLLC Past Accepting new patients
Privia Medical Group West Texas, PLLC Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Organizations & group practices 3

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1689663403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E LIVINGSTON ST",
            "city": "SAN AUGUSTINE",
            "state": "TX",
            "postal_code": "759722028",
            "telephone_number": "936-275-9910",
            "fax_number": "936-275-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 HIGH RIDGE CT",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762341775",
            "telephone_number": "325-829-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNAN",
        "first_name": "FLOYD",
        "middle_name": "ARTHUR",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K9563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036724504",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036724502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036724506",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

Verify at the official NPI Registry.