Justin Travis Henson, DC, ATC, LAT, LMT

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

14629 Issued in TX

Practice address

4130 FM 762 Rd Ste 300
Rosenberg, TX 77469-6436

Phone

(281) 324-8292

NPI assigned

Nov 9, 2015

Last updated

Jan 15, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1780057091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "address_2": "911 ATLANTIC AVENUE",
            "city": "BOLING",
            "state": "TX",
            "postal_code": "774200182",
            "telephone_number": "979-257-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 FM 762 RD STE 300",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774696436",
            "telephone_number": "281-324-8292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Boling",
            "state": "TX",
            "postal_code": "77420",
            "country_code": "US",
            "telephone_number": "979-257-6183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSON",
        "first_name": "JUSTIN",
        "middle_name": "TRAVIS",
        "name_prefix": "Mr.",
        "credential": "DC, ATC, LAT, LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-09",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6352",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Rosenberg, TX
• Providers in Rosenberg, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.