Provider Demographics
NPI:1982667523
Name:A CARL HENRY MD PA
Entity Type:Organization
Organization Name:A CARL HENRY MD PA
Other - Org Name:PROFESSIONAL ASSOCIATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:214-821-3603
Mailing Address - Street 1:8111 LBJ FREEWAY
Mailing Address - Street 2:STE 835
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251
Mailing Address - Country:US
Mailing Address - Phone:972-437-2577
Mailing Address - Fax:972-644-3810
Practice Address - Street 1:3409 WORTH ST
Practice Address - Street 2:STE 720
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:214-821-3603
Practice Address - Fax:214-823-1317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00533RMedicare PIN