Provider Demographics
NPI:1639185010
Name:HENDERSON, PATRICK BOUVIER
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:BOUVIER
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E ARAPAHO RD
Mailing Address - Street 2:SUITE# 313
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2778
Mailing Address - Country:US
Mailing Address - Phone:972-235-4200
Mailing Address - Fax:972-235-2300
Practice Address - Street 1:500 E ARAPAHO RD
Practice Address - Street 2:SUITE# 313
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2778
Practice Address - Country:US
Practice Address - Phone:972-235-4200
Practice Address - Fax:972-235-2300
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies