Active NPI
Cory Lynn Henson, M.D.
- Pediatrics Physician
- San Antonio, TX
National Provider Identifier
1962846006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- BP1-0045915
- Practice address
- 333 N Santa Rosa St
San Antonio, TX 78207-3108 - Phone
- (210) 704-2011
- NPI assigned
- Apr 19, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | BP1-0045915 | TX | Primary |
Addresses
Primary practice location
333 N Santa Rosa St
San Antonio, TX 78207-3108
Mailing address
315 N San Saba Ste 1135
San Antonio, TX 78207-3255
Phone (210) 704-3030
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190727000021 | TX | Practitioner - Pediatric Medicine | 3971875287 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP1-0045915 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baylor College of Medicine | Pediatrics | Current | Accepting new patients |
| Christus Santa Rosa Health Care Corporation | Past | Accepting new patients |
Locations
4900 Mueller Blvd
Ste 3S66C
Austin, TX 78723
Phone (512) 324-0165
2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835
333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190
Organizations & group practices 2
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.
-
- Children's Hospital
- San Antonio, TX
- NPI 1821004151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1962846006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 N SAN SABA STE 1135",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782073255",
"telephone_number": "210-704-3030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N SANTA ROSA ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782073108",
"telephone_number": "210-704-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENSON",
"first_name": "CORY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-19",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "BP1-0045915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.