Provider Demographics
NPI:1689687675
Name:HENSON, ALAN STEWART (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:STEWART
Last Name:HENSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 W PIONEER PKWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-6106
Mailing Address - Country:US
Mailing Address - Phone:817-461-6374
Mailing Address - Fax:817-461-8550
Practice Address - Street 1:1833 W PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6106
Practice Address - Country:US
Practice Address - Phone:817-461-6374
Practice Address - Fax:817-461-8550
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU84787Medicare UPIN
TX607043Medicare ID - Type Unspecified