Provider Demographics
NPI:1497016638
Name:HENRA INC.
Entity type:Organization
Organization Name:HENRA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:KRUEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-617-6899
Mailing Address - Street 1:3200 TROUP HWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8397
Mailing Address - Country:US
Mailing Address - Phone:903-617-6899
Mailing Address - Fax:903-747-3804
Practice Address - Street 1:3200 TROUP HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8397
Practice Address - Country:US
Practice Address - Phone:903-617-6899
Practice Address - Fax:903-747-3804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health