Provider Demographics
NPI:1518927557
Name:HENRY, ALBERT CARL III (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:CARL
Last Name:HENRY
Suffix:III
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 1:3214 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-2925
Mailing Address - Country:US
Mailing Address - Phone:214-236-5421
Mailing Address - Fax:
Practice Address - Street 1:621 N HALL ST STE 108
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1321
Practice Address - Country:US
Practice Address - Phone:214-236-5421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2610208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
C16824Medicare UPIN
TX8155N0Medicare PIN