Provider Demographics
NPI:1619389798
Name:R, ASHER HENEGAR
Entity Type:Organization
Organization Name:R, ASHER HENEGAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:REX
Authorized Official - Middle Name:ASHER
Authorized Official - Last Name:HENEGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-255-6160
Mailing Address - Street 1:3626 N MACARTHUR BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3643
Mailing Address - Country:US
Mailing Address - Phone:972-255-6160
Mailing Address - Fax:
Practice Address - Street 1:3626 N MACARTHUR BLVD STE 129
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3643
Practice Address - Country:US
Practice Address - Phone:972-255-6160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX273391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1992084529Medicaid