Illum, Henrik B
Illum, Henrik B is an individual health care provider with primary practice located at 1615 Hospital Parkway Suite 300, Bedford TX 76022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Illum, Henrik B can be contacted via phone (817) 354-5581.Contact Information
Primary practice address
1615 Hospital Parkway Suite 300
Bedford TX 76022
Phone: (817) 354-5581
Fax: (817) 359-9062
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | N0118 | Texas |
Profile Details
| NPI number | 1982805164 |
|---|---|
| LBN Legal business name | Illum, Henrik B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 29th, 2007 |
| Last updated | Jun 25th, 2015 - about 10 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 | 1982805164 | NPPES |
| Texas | MEDICAID | 194728503 | |
| Texas | Other | P01449276 |
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