| Doctor Name: | PHILLIP HENDERSON |
| NPI Number: | 1477951846 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DVM |
| License Number: | 3671 |
| Business Practice Address: | 601 Shaffner St Ponder, TX - 762597002 |
| Business Phone Number: | 9404792782 |
| Business Fax Number: | 9404792675 |
| Mailing Address: | 601 Shaffner St, PONDER |
| State: | TX |
| Postal Code: | 762597002 |
| Phone Number: | 9404792782 |
| Fax Number: | 9404792675 |
| NPI Enumeration Date: | 12/16/2014 |
| NPI Last Update Date: | 12/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174M00000X |
| License Number: | 3671 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Veterinarian |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |