Provider Demographics
NPI:1508475450
Name:HENDERSON, CHARMAURA D (BS, ATC, MS, DC)
Entity Type:Individual
Prefix:DR
First Name:CHARMAURA
Middle Name:D
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:BS, ATC, MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 RIDGE POINT LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7039
Mailing Address - Country:US
Mailing Address - Phone:314-600-1821
Mailing Address - Fax:
Practice Address - Street 1:3000 CUSTER RD STE 260
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4427
Practice Address - Country:US
Practice Address - Phone:214-494-9553
Practice Address - Fax:214-975-5979
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT81552255A2300X
TX14888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer