Provider Demographics
NPI:1265665566
Name:JOSE G. HENAO, DPM PLLC
Entity Type:Organization
Organization Name:JOSE G. HENAO, DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.M.
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:HENAO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:956-541-4849
Mailing Address - Street 1:PO BOX 3536
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78523-3536
Mailing Address - Country:US
Mailing Address - Phone:956-541-4849
Mailing Address - Fax:956-982-1629
Practice Address - Street 1:848 RIDGEWOOD ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8646
Practice Address - Country:US
Practice Address - Phone:956-541-4849
Practice Address - Fax:956-982-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1613P213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty