Provider Demographics
NPI:1093795221
Name:NANCE, HENRY H JR (DO)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:H
Last Name:NANCE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:141 WESTMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-4126
Mailing Address - Country:US
Mailing Address - Phone:817-645-2122
Mailing Address - Fax:817-645-2112
Practice Address - Street 1:141 WESTMEADOW DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4126
Practice Address - Country:US
Practice Address - Phone:817-645-2122
Practice Address - Fax:817-645-2112
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG3038208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114461001Medicaid
TX114461001Medicaid
TXA67437Medicare UPIN