Provider Demographics
NPI:1316935356
Name:HIGGINS, HENRY L (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:L
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 E WHITESTONE BLVD STE 1100
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-9058
Mailing Address - Country:US
Mailing Address - Phone:737-787-7809
Mailing Address - Fax:
Practice Address - Street 1:1464 E WHITESTONE BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-9058
Practice Address - Country:US
Practice Address - Phone:737-787-7809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6232207Q00000X, 207QA0401X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161292101Medicaid
G58136Medicare UPIN
TX161292101Medicaid