Eddie Michael Henderson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA03311 Issued in TX

Practice address

101 E Jackson St
Burnet, TX 78611-3101

Phone

(512) 756-7510

NPI assigned

Oct 27, 2006

Last updated

Jul 8, 2012By 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

Other identifiers 1

Other names 1

• Mr. Michael Henderson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ector County Hospital District

  dba MCH Urgent Care

  • Urgent Care Clinic/Center
  • Odessa, TX
  • NPI 1366680555
  NPD (past)
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796
  NPD (past)
• Scott & White Memorial Hospital

  dba Baylor Scott & White Hospice - Austin

  • Community Based Hospice Care Agency
  • Round Rock, TX
  • NPI 1891468591
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341705600000",
    "number": "1801971676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E JACKSON ST",
            "city": "BURNET",
            "state": "TX",
            "postal_code": "786113101",
            "telephone_number": "512-756-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E JACKSON ST",
            "city": "BURNET",
            "state": "TX",
            "postal_code": "786113101",
            "telephone_number": "512-756-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "EDDIE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03311",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "NM2008-0046",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57551251",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "HENDERSON",
            "prefix": "MR.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Julia Grace Guillot, PT, DPT
• H-E-B, LP (HEB Pharmacy #433)
• Robert Lee Harding Jr., DO
• Hcmeq (Hill Country Medical Equipment)
• Camille Hemlock, MD
• Bobby Jo Henry, R.PH.
• Lurenda Gayle Henry
• Susan Elizabeth Henson, DMD
• Michael Anthony Herrera, PHARM.D
• Hill Country Advanced Foot and Ankle Center, P.a.

• Medical Physician Assistant in Burnet, TX
• Providers in Burnet, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2012; 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.