Basic Information
Provider Information
NPI: 1356788756
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HENDRYX
FirstName: JOEL
MiddleName: TRAVIS
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9401 SOUTHWEST FWY
Address2:  
City: HOUSTON
State: TX
PostalCode: 770741407
CountryCode: US
TelephoneNumber: 7139707000
FaxNumber: 7139707246
Practice Location
Address1: 9401 SOUTHWEST FWY
Address2:  
City: HOUSTON
State: TX
PostalCode: 770741407
CountryCode: US
TelephoneNumber: 7139707000
FaxNumber: 7139707246
Other Information
ProviderEnumerationDate: 05/27/2013
LastUpdateDate: 01/12/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XQ5666TXY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
390200000X TXN Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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