Provider Demographics
NPI:1073714697
Name:PATRICK B. HENDERSON
Entity Type:Organization
Organization Name:PATRICK B. HENDERSON
Other - Org Name:KARMA MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:BOUVIER
Authorized Official - Last Name:HENDESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-235-4200
Mailing Address - Street 1:500 E ARAPAHO RD
Mailing Address - Street 2:313
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2765
Mailing Address - Country:US
Mailing Address - Phone:972-235-4200
Mailing Address - Fax:972-235-2300
Practice Address - Street 1:500 E ARAPAHO RD
Practice Address - Street 2:313
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2765
Practice Address - Country:US
Practice Address - Phone:972-235-4200
Practice Address - Fax:972-235-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0090326332BC3200X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183415201Medicaid
TX183415201Medicaid