Jeffrey Mark Henderson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

L 9240 Issued in TX

Practice address

430 W Bandera Rd Ste 9
Boerne, TX 78006-2521

Phone

(830) 249-1717

Fax

(830) 816-2103

NPI assigned

Nov 7, 2005

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 1

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

Interoperability endpoints

• Direct secure messaging: jeffrey.henderson@commsa.eclinicaldirectplus.com

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.

• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1902883739
  Medicare reassignment NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Marcos, TX
  • NPI 1295601052
  NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1952690463
  NPD

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912988007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7062",
            "fax_number": "210-434-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W BANDERA RD STE 9",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062521",
            "telephone_number": "830-249-1717",
            "fax_number": "830-816-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JEFFREY",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L 9240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185711202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heart Consultants of San Antonio, PLLC
• Heartland Nursing ENT
• Denise Vargas Heinen
• Joshua Samuel Heinrich, PT, DPT
• Michelle Lynn Helms, OT
• Jessica Andrea Henderson, NP
• Gavin Eric Hernandez, M.ED
• Karol Hernandez
• Sabrina Hernandez
• Cristina Marie Herrera, OTR

• Pediatrics Physician in Boerne, TX
• Providers in Boerne, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.