Provider Demographics
NPI:1649500331
Name:HENSLER, JB
Entity type:Individual
Prefix:
First Name:JB
Middle Name:
Last Name:HENSLER
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 1:1715 ALTA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-3001
Mailing Address - Country:US
Mailing Address - Phone:281-388-0110
Mailing Address - Fax:281-585-0709
Practice Address - Street 1:1620 S GORDON ST
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-3460
Practice Address - Country:US
Practice Address - Phone:281-585-2404
Practice Address - Fax:281-585-0709
Is Sole Proprietor?:No
Enumeration Date:2010-01-03
Last Update Date:2010-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist