Provider Demographics
NPI:1033396080
Name:SCOTT M HENSLEE,M.D.,P.A.
Entity Type:Organization
Organization Name:SCOTT M HENSLEE,M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-614-3575
Mailing Address - Street 1:7950 FLOYD CURL DR
Mailing Address - Street 2:SUITE 909
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3919
Mailing Address - Country:US
Mailing Address - Phone:210-614-3575
Mailing Address - Fax:210-692-7116
Practice Address - Street 1:7950 FLOYD CURL DR
Practice Address - Street 2:SUITE 909
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3919
Practice Address - Country:US
Practice Address - Phone:210-614-3575
Practice Address - Fax:210-692-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3332174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH61715Medicare UPIN
TX00635TMedicare PIN