Henderson, Brett R
Henderson, Brett R is an individual health care provider with primary practice located at 3850 E Lohman Ave Suite C, Las Cruces NM 88011-8288. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurological Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Henderson, Brett R can be contacted via phone (575) 522-1974.Contact Information
Primary practice address
3850 E Lohman Ave Suite C
Las Cruces NM 88011-8288
Phone: (575) 522-1974
Fax: (575) 522-5209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 2001-213 | New Mexico |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 2001-213 | New Mexico |
Profile Details
| NPI number | 1598818189 |
|---|---|
| LBN Legal business name | Henderson, Brett R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Jun 26th, 2015 - about 9 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 | 1598818189 | NPPES |
| New Mexico | MEDICAID | F1792 | |
| New Mexico | Other | NM019Y53 | |
| New Mexico | Other | P00459212 |
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