Carson Henderson, Stephanie Renee
Carson Henderson, Stephanie Renee is an individual health care provider with primary practice located at 1201 S Main St , Fort Worth TX 76104-4804. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Carson Henderson, Stephanie Renee can be contacted via phone (817) 702-6500.Contact Information
Primary practice address
1201 S Main St
Fort Worth TX 76104-4804
Phone: (817) 702-6500
Fax: (817) 927-6559
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | L4878 | Texas |
Profile Details
| NPI number | 1952386104 |
|---|---|
| LBN Legal business name | Carson Henderson, Stephanie Renee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 9th, 2005 |
| Last updated | Oct 1st, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952386104 | NPPES |
| Texas | Other | 8A0452 | BCBS |
| Texas | Other | 8DP282 | BCBS |
| Texas | Other | P01379268 | BCBS |
| Texas | MEDICAID | 1578189-01 | BCBS |
| Texas | MEDICAID | 157818903 | BCBS |
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