Provider Demographics
NPI:1831411719
Name:HENRY, MICHAEL PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:HENRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4601 SOUTHWEST PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8938
Mailing Address - Country:US
Mailing Address - Phone:512-899-2228
Mailing Address - Fax:512-899-2226
Practice Address - Street 1:4601 SOUTHWEST PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8938
Practice Address - Country:US
Practice Address - Phone:512-899-2228
Practice Address - Fax:512-899-2226
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor