Provider Demographics
NPI:1548561871
Name:HENDERSON, JENNIFER BURK (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BURK
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 LAKE POINTE PKWY STE 416
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3499
Mailing Address - Country:US
Mailing Address - Phone:281-494-0050
Mailing Address - Fax:
Practice Address - Street 1:1327 LAKE POINTE PKWY STE 416
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3499
Practice Address - Country:US
Practice Address - Phone:281-494-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical