Provider Demographics
NPI:1831295021
Name:CARDER, HENRY MAURICE (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:MAURICE
Last Name:CARDER
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 1:8315 WALNUT HILL LANE
Mailing Address - Street 2:#135
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-369-8121
Mailing Address - Fax:214-363-8530
Practice Address - Street 1:8315 WALNUT HILL LANE
Practice Address - Street 2:SUITE 135
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-369-8121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD0823207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
611760OtherAETNA
TXL760OtherBCBS
C14192Medicare UPIN