Provider Demographics
NPI:1164602512
Name:MICHAEL A. MCHENRY, M.D., P.A.
Entity Type:Organization
Organization Name:MICHAEL A. MCHENRY, M.D., P.A.
Other - Org Name:CONSULTING PHYSICAL MEDICINE & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCHENRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-942-3676
Mailing Address - Street 1:PO BOX 678680
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8680
Mailing Address - Country:US
Mailing Address - Phone:214-942-3676
Mailing Address - Fax:214-942-1812
Practice Address - Street 1:810 N ZANG BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4233
Practice Address - Country:US
Practice Address - Phone:214-942-3676
Practice Address - Fax:214-942-1812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8053208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty