DR. RANDALL DALE HENDERSON (DO) – Family Medicine Physician, NPI 1700879848

DR. RANDALL DALE HENDERSON (DO) is a healthcare provider. based in Whitney, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. L1340 (TX). The NPI Number for DR. RANDALL DALE HENDERSON (DO) is 1700879848

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. RANDALL DALE HENDERSON (DO)
NPI
1700879848
Phone
(254) 694-3621
Address
1314 N BRAZOS ST
Enumeration Date
24 August 2005
Last Update Date
2 March 2015

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Secondary Phone
2546943621
Graduation Year
1999 (27 years ago)
PAC ID
4486645215
Group Practice PAC ID
3274759303
Professional Enrollment ID
I20110308001010
Address ID
TX766922010WH1314XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

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Provider Addresses for DR. RANDALL DALE HENDERSON (DO)

  • Brazos Street, Whitney, Hill County, Texas, 76692, United States

    WHITNEY, TX 766922010

    Phone: (254) 694-3621

    Fax: (254) 694-7436

    Type: Location

  • PO BOX 2177

    WHITNEY, TX 766925177

    Phone: (254) 694-3621

    Fax: (254) 694-7436

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 200 Open Payments records for all available years, with a total value of $3,394.

Total Amount is formed as General ($3,394) + Research ($0) + Ownership ($0) = $3,394.

Last reported payment date: 2024-12-26 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($412).

Total Amount

$3,394

General + Research + Ownership

Payments

200

Total payment records

General Amount

$3,394

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-26

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-03-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110308001010IFamily PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
81002Urinalysis, manual test157103$0
71046X-ray of chest, 2 views4340$0
99213Established patient office or other outpatient visit, 20-29 minutes4220$0
87426Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus2420$0
99214Established patient office or other outpatient visit, 30-39 minutes2111$0
View full utilization report →

Insurance plans in this area (ZIP 76692)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274759303View full group profile
NameSpecialtyState
Nurse PractitionerTX
Clinical Social WorkerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

How do payers reference DR. RANDALL DALE HENDERSON (DO)?
For DR. RANDALL DALE HENDERSON (DO), use NPI 1700879848 as the unique 10-digit identifier.
Is DR. RANDALL DALE HENDERSON (DO) still an active registrant?
DR. RANDALL DALE HENDERSON (DO) carries an active NPI according to the public dataset.
What clinical focus is listed for DR. RANDALL DALE HENDERSON (DO)?
At a glance, DR. RANDALL DALE HENDERSON (DO) is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Texas is DR. RANDALL DALE HENDERSON (DO) registered?
Use Whitney, Texas as the headline location for DR. RANDALL DALE HENDERSON (DO) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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