Provider Demographics
NPI:1447561253
Name:HENRY, ERIC D SR
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:D
Last Name:HENRY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13940 BAMMEL NORTH HOUSTON
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-2950
Mailing Address - Country:US
Mailing Address - Phone:281-580-4400
Mailing Address - Fax:281-580-4432
Practice Address - Street 1:13940 BAMMEL NORTH HOUSTON
Practice Address - Street 2:SUITE 303
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-2950
Practice Address - Country:US
Practice Address - Phone:281-580-4400
Practice Address - Fax:281-580-4432
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000296332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies