JEFFREY MARK HENDERSON (NPI# 1912988007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912988007 |
| Entity Type | Individual |
| Full Name | JEFFREY MARK HENDERSON |
| Credential | MD |
| Practice Address |
430 W Bandera Rd Ste 9 Boerne TX 78006-2521 |
| Mailing Address |
3066 E Commerce St San Antonio TX 78220-1013 |
| Practice Telephone | 8302491717 |
| Practice Fax Number | 8308162103 |
| Mailing Telephone | (210) 233-7062 |
| Mailing Fax Number | 2104341704 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2017-08-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | L 9240 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 185711202 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942465026 | Jeffrey Thomas Henderson | Pathology | 1300 N 12th St Ste 300, Phoenix, AZ 85006-2813 | 2008-07-28 |
| 1194860171 | Jeffrey Henderson | Physical Therapist | 107 Pinkerton Dr, Beaver, PA 15009-1213 | 2007-02-20 |
| 1598856049 | Jeffrey A. Henderson | Internal Medicine | 3200 Canyon Lake Drive, Rapid City, SD 57702 | 2006-09-28 |
| 1528026978 | Jeffrey Lynn Henderson | Emergency Medicine | 390 N Main St, Bountiful, UT 84010-6046 | 2006-05-03 |
| 1578111258 | Jeffrey Lee Henderson Jr. | Pharmacist | 300 W 19th Ter, Kansas City, MO 64108-2026 | 2019-08-27 |
| 1164994638 | Jeffrey N Henderson | Peer Specialist | 149 W 12th Ave, Eugene, OR 97401-3408 | 2018-12-21 |
| 1326315185 | Jeffrey Coleman Henderson | Case Manager/Care Coordinator | 5050 Madison Rd, Cincinnati, OH 45227-1491 | 2011-11-22 |
| 1235386848 | Jeffrey Harris Henderson | Family Medicine | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2008-08-26 |
| 1821173899 | Jeffrey Scott Henderson | Social Worker | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2006-10-26 |
| 1649354572 | Jeffrey W Henderson | Internal Medicine | 200 Center Street, Ludlow, MA 01056 | 2006-10-25 |
| Street Address |
430 W BANDERA RD STE 9 |
| City | BOERNE |
| State | TX |
| Zip Code | 78006-2521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710486824 | Veronica Cordero Cisneros | Nurse Practitioner | 430 W Bandera Rd Ste 9, Boerne, TX 78006-2521 | 2018-02-04 |
| 1972641272 | Daniel Ernest Kasprowicz Jr. | Physical Therapist | 430 W Bandera Rd Ste 9, Boerne, TX 78006-2521 | 2007-02-01 |
| 1205848298 | Martha Medrano | Psychiatry & Neurology | 430 W Bandera Rd Ste 9, Boerne, TX 78006-2521 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218517 | Boerne Mens Clinic | Family Medicine | 138 Tx-46, Boerne, TX 78006 | 2020-09-01 |
| 1700431798 | Methodist Ambulatory Surgery Center of Boerne, LLC | Clinic/Center | 110 Menger Springs, Boerne, TX 78006 | 2019-08-06 |
| 1144704156 | Lauren Elizabeth Settle | Counselor | 26254 Interstate 10, Suite 224, Boerne, TX 78006 | 2018-09-17 |
| 1265914600 | Shana North | Physical Therapy Assistant | 200 Ryan Street, Boerne, TX 78006 | 2018-09-02 |
| 1598258352 | Alamo Prosthetics LLC | Durable Medical Equipment & Medical Supplies | 28711 I 10 W, Boerne, TX 78006 | 2018-06-07 |
| 1578052312 | Premium Pharma, LLC | Pharmacy | 1 Fm 3351 S Ste 115, Boerne, TX 78006 | 2018-05-08 |
| 1952814386 | Advanced Surgical Care of Boerne, LLC | Clinic/Center | 138 Old San Antonio Rd # 400, Boerne, TX 78006 | 2017-11-07 |
| 1184151532 | River Road Pharmacy | Pharmacy | 910 River Rd Ste 103, Boerne, TX 78006 | 2017-05-16 |
| 1487191565 | Olive Branch Hope Center, Inc | Counselor | 215 W Bandera Rd 114 Pmb 239, Boerne, TX 78006 | 2017-01-26 |
| 1063955367 | Leigh Ann Grasso | Pharmacist | 31007 Ih 10 W, Ste 108, Boerne, TX 78006 | 2016-11-18 |
| Find all providers in zip 78006 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720379506 | Shalini Boggarapu | Pediatrics | 138 Old San Antonio Rd Ste 101, Boerne, TX 78006-3491 | 2011-04-27 |
| 1598761066 | Vincent N. Coleman | Pediatrics | 430 W Bandera Rd, Ste 9, Boerne, TX 78006-2500 | 2005-06-21 |
| 1093710451 | Michelle Marie Arandes | Pediatrics | 34910 Ih 10 W, Ste 501, Boerne, TX 78006-9230 | 2005-06-14 |
| 1790310084 | Boerne Pediatrics | Pediatrics | 138 Old San Antonio Rd Ste 101, Boerne, TX 78006-3491 | 2020-03-06 |
| 1952680639 | Jared Scott Brockington | Pediatrics | 117 W Highland Dr, Suite 201, Boerne, TX 78006-2651 | 2011-08-11 |
| 1134396757 | Rachel Aubrey Gravel | Pediatrics | 124 E Bandera Rd, Suite 304, Boerne, TX 78006-2849 | 2008-05-13 |
| 1477617470 | Anne D Logan Mdpa | Pediatrics | 124 E Bandera Rd, Suite 304, Boerne, TX 78006-2849 | 2006-12-21 |
| 1790876225 | Cheryl Ann Trexler | Pediatrics | 430 W Bandera Rd, Ste., 9, Boerne, TX 78006-2500 | 2006-09-28 |
| 1700978897 | A Plus Pediatrics, Pa | Pediatrics | 34910 Ih 10 W, 501, Boerne, TX 78006-9229 | 2006-09-28 |
| 1902830318 | Sheralyn Deborah Wood | Pediatrics | 124 E Bandera Rd, Suite 304, Boerne, TX 78006-2849 | 2006-07-10 |
| Find all providers in BOERNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.