Provider Demographics
NPI:1386700029
Name:HENDERSON, WILLIAM THOMAS II (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:HENDERSON
Suffix:II
Gender:M
Credentials:OD
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Mailing Address - Street 1:3710 RAWLINS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219
Mailing Address - Country:US
Mailing Address - Phone:214-953-3937
Mailing Address - Fax:214-953-1892
Practice Address - Street 1:3710 RAWLINS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219
Practice Address - Country:US
Practice Address - Phone:214-953-3937
Practice Address - Fax:214-953-1892
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX4269TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist