Individual provider Active NPI

Bruce Beaumont Henry, M.D.

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1861404824
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G7472 Issued in TX
Practice address
7777 Forest LN
A222
Dallas, TX 75230-2505
Phone
(972) 566-7970
Fax
(972) 566-3821
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 G7472 TX Primary

Addresses

Primary practice location

7777 Forest LN
A222
Dallas, TX 75230-2505

Mailing address

7777 Forest LN
A222
Dallas, TX 75230
Phone (972) 566-7970

Other identifiers 1

IdentifierTypeStateIssuer
84160XOtherTXBCBS

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
I20110125001256 TX Practitioner - Family Practice 3971782749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1969
Medicare assignment
May accept Medicare assignment
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

7777 Forest Lane
A222
Dallas, TX 75230-2560

7777 Forest LN
Dallas, TX 75230-2560
Phone (972) 566-7970

800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Family Healthcare,P.a. Family Medicine CurrentSince Oct 5, 1998 Accepting new patients
Fitstar Physical Therapy Past Accepting new patients

Locations

7777 Forest Ln
Ste A222
Dallas, TX 75230
Phone (972) 566-7970

Interoperability endpoints

  • Direct secure messaging: bruce.henry@tfhp.eclinicaldirectplus.com

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861404824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "A222",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "972-566-7970",
            "fax_number": "972-566-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "A222",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-7970",
            "fax_number": "972-566-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "BRUCE",
        "middle_name": "BEAUMONT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G7472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84160X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.