Henderson, Samuel A

Henderson, Samuel A is an individual health care provider with primary practice located at 707 Hollybrook Dr , Longview TX 75605-2410. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Henderson, Samuel A can be contacted via phone (903) 757-6042.

Contact Information

Primary practice address
707 Hollybrook Dr Longview TX 75605-2410
Phone: (903) 757-6042
Fax: (903) 232-8226
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X P2668 Texas
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 206777 Louisiana
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X P2668 Texas

Profile Details

NPI number 1174782353
LBN Legal business name Henderson, Samuel A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2008
Last updated Feb 21st, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174782353 NPPES
Texas MEDICAID 350346803

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