NPI age
8 years
Enumerated 2018-02-12
● Active Type 2 · Organization
Subpart
Henderson Hospital, Llc
Henderson Hospital, Llc is 1 of 689 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Petrovich
Evp
Last NPPES update
2023-10-01
Source: monthly bulk 2026-05
How this organization compares
Across 689 active clinic/center providers in Texas.
NPI age
8 years
↓ 6 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2018 → 2026
2018-02Enumerated in NPPES
2018
2026
Where they practice
Primary practice location
300 Wilson St
Henderson, TX 756525956
Mailing address
340 Seven Springs Way Ste 100
Brentwood, TN 370275697
Authorized official
Stephen C. Petrovich
Evp
📞 6152963000
Individual providers at this organization
16 individual providers on file at this primary practice address.
- Jathan Cantu, M.D. Family Medicine NPI 1932174596
- Joseph Carver, D.O. Family Medicine NPI 1720408909
- Glena Davis, D.O. Obstetrics & Gynecology NPI 1932383981
- Nino Fuller, AGACNP-BC Nurse Practitioner NPI 1962974469
- Mark Hackbarth, MD Anesthesiology NPI 1629071527
- Dwight Hall, CRNA Nurse Anesthetist, Certified Registered NPI 1770582736
- Mica Norman, PMHNP-BC, FNP-C Nurse Practitioner NPI 1053953794
- Cheryl Polkowski, M.D. Family Medicine NPI 1194882241
- Adam Ranginwala, MD Emergency Medicine NPI 1114422623
- Bruno Romeo Miramon, MD Obstetrics & Gynecology NPI 1366564148
- Shawna Sharp, NP Nurse Practitioner NPI 1255954509
- Nicole Stanley, NP Nurse Practitioner NPI 1730732942
- Amanda Trubey, MSN, FNP-C Nurse Practitioner NPI 1205569761
- Gordon Uretsky, MD Family Medicine NPI 1477512820
- Angela Vera, RD, LD Dietitian, Registered NPI 1356626782
- Jerry Wheeler, CRNA Nurse Anesthetist, Certified Registered NPI 1376672006
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 16 individual providers on file at this primary address.
Subpart of Ahs East Texas Health System, Llc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.