Provider Demographics
NPI:1871083287
Name:HENRY, PAUL A
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:A
Last Name:HENRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11226 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-3604
Mailing Address - Country:US
Mailing Address - Phone:281-495-1980
Mailing Address - Fax:281-495-1987
Practice Address - Street 1:11226 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031
Practice Address - Country:US
Practice Address - Phone:281-495-1980
Practice Address - Fax:281-495-1987
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2023-05-16
Deactivation Date:2019-09-03
Deactivation Code:
Reactivation Date:2023-05-16
Provider Licenses
StateLicense IDTaxonomies
TX31891183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist