Provider Demographics
NPI:1558466052
Name:HENRY H. HERRERA, M.D., P.A.
Entity Type:Organization
Organization Name:HENRY H. HERRERA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-699-6377
Mailing Address - Street 1:PO BOX 2355
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78298-2355
Mailing Address - Country:US
Mailing Address - Phone:210-699-6377
Mailing Address - Fax:210-699-1127
Practice Address - Street 1:8127 N NEW BRAUNFELS AVE APT 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2126
Practice Address - Country:US
Practice Address - Phone:210-699-6377
Practice Address - Fax:210-699-1127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6413207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0028PYOtherBCBS GROUP
TX149001301Medicaid
TX0028PYOtherBCBS GROUP
TX00036TMedicare PIN