Provider Demographics
NPI:1619919008
Name:GELENDER, HENRY (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:GELENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 730486
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-0486
Mailing Address - Country:US
Mailing Address - Phone:214-692-0146
Mailing Address - Fax:214-692-1698
Practice Address - Street 1:10740 N CENTRAL EXPY
Practice Address - Street 2:SUITE 350
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2161
Practice Address - Country:US
Practice Address - Phone:214-692-0146
Practice Address - Fax:214-692-1698
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6296207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X1372OtherBCBS
TX134596908Medicaid
TX8X1372OtherBCBS
TX8F4282Medicare PIN
TX134596908Medicaid