Provider Demographics
NPI:1992084529
Name:HENEGAR, REX ASHER (DDS)
Entity type:Individual
Prefix:DR
First Name:REX
Middle Name:ASHER
Last Name:HENEGAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 INNISBROOK DR S
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3412
Mailing Address - Country:US
Mailing Address - Phone:972-659-1355
Mailing Address - Fax:972-409-0587
Practice Address - Street 1:1675 BRIARGATE BLVD STE A
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3416
Practice Address - Country:US
Practice Address - Phone:719-896-4256
Practice Address - Fax:719-896-4818
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-13
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002030861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice