Provider Demographics
NPI:1588016067
Name:HENDERSON, BARTHOLOMEW (DNP, CRNA)
Entity Type:Individual
Prefix:DR
First Name:BARTHOLOMEW
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9273 MEANDERING DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-3273
Mailing Address - Country:US
Mailing Address - Phone:682-224-9853
Mailing Address - Fax:
Practice Address - Street 1:9273 MEANDERING DR
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-3273
Practice Address - Country:US
Practice Address - Phone:682-224-9852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131697367500000X, 367500000X
TX757899163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered