Samuel Pachis Henry, RBT
Technician, Other in Fort Worth, TX. Individual provider (NPI-1).
NPI number1083170138
StatusActive
Last updated in NPPESOct 2, 2019
Details
- NPI
- 1083170138
- Entity type
- Individual (NPI-1)
- Name
- Samuel Pachis Henry
- Credential
- RBT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 13, 2019
- Last updated
- Oct 2, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | RBT-18-53975 | – | Yes |
Practice location
12650 N Beach St Ste 146Fort Worth, TX 76244-4253
Phone 682-238-1872
Mailing address
16800 Dallas Pkwy Ste 200Dallas, TX 75248-1961
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