Clyde Henke, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

E4399 Issued in TX

Practice address

3501 Knickerbocker Rd
Williams Family Center
San Angelo, TX 76904-7610

Phone

(325) 245-4000

NPI assigned

Apr 6, 2006

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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585
  NPD
• Regional Employee Assistance Program Inc

  • General Practice Physician
  • San Angelo, TX
  • NPI 1750302923
  NPD

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1770545386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 KNICKERBOCKER RD",
            "address_2": "WILLIAMS FAMILY CENTER",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-245-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 KNICKERBOCKER RD",
            "address_2": "WILLIAMS FAMILY CENTER",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-245-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "CLYDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "E4399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8U8630",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117683604",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Hejny, OD
• Heather Renee Helwig, PT
• Cassandra Jane Henderson
• Shawna M Henderson
• Kelsey Jo Hendrix, PT, DPT
• Jean Lynn Henrikson, NP
• Kimberly Anne Henry, LMSW
• David Christopher Henson, D.D.S.
• Erin Elisabeth Henson, DDS
• David Charles Herbert, M.D.

• Obstetrics & Gynecology Physician in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.