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HENDERSON FAMILY MEDICINE, PLLC
NPI 1831415793
Family Medicine in Henderson, TX

Active since April 15, 2010CLIA 45D2006203 · Waiver
105 N HIGH ST, HENDERSON, TX 75652(903) 235-0086(903) 657-1674 Get Directions Write a Review

NPPES record last updated: April 15, 2010. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Henderson Family Medicine, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HENDERSON FAMILY MEDICINE, PLLC (NPI 1831415793) is a healthcare organization registered as a family medicine in Henderson, Texas and active in the NPI registry since April 2010. The organization holds a CLIA Waiver certificate valid through April 13, 2028 and lists Tad Titlow, Owner, as its authorized official.

NPPES Registry Identity

NPI1831415793
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHENDERSON FAMILY MEDICINE, PLLC
Location Address105 N HIGH STHenderson, TX 75652-3133
Mailing Address105 N High StHenderson, TX 75652-3133 · (903) 235-0086 · Fax (903) 657-1674
Phone(903) 235-0086
Fax(903) 657-1674
Organization SubpartNo
Authorized OfficialTad TitlowOwner · (903) 235-0086
Enumeration DateApril 15, 2010
✔ NPI 1831415793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · L1106
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
105 N HIGH ST, Henderson, TX 75652
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Other Identifiers 1

Medicare UPINH43392TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Henderson Family Medicine, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Henderson Family Medicine, PLLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Michael Colotta, FNP-C
Nurse Practitioner
NPI 1477824340
105 N HIGH ST
Henderson, TX 75652
(903) 392-8259
✔ PECOS✔ Accepts MedicareSame address
Alicia Juarez, APRN-CNP
Nurse Practitioner
NPI 1679258321
105 N HIGH ST
Henderson, TX 75652
(903) 392-8259
✔ PECOS✔ Accepts MedicareSame address
Tad Titlow, APN-C
Nurse Practitioner
NPI 1073725669
105 NORTH HIGH STREET
Henderson, TX 75652
(903) 392-8259
✔ PECOS✔ Accepts MedicareSame address
Upali Walgama, MD
Internal Medicine
NPI 1265577175
105 N HIGH ST
Henderson, TX 75652
(903) 392-8259
✔ PECOS✔ Accepts MedicareSame address
Sally Thompson, FNP-C
Nurse Practitioner
NPI 1003249558
3515 RICHMOND RD
Texarkana, TX 75503
(903) 791-9355
✔ PECOS✔ Accepts Medicare99 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2006203

Henderson Family Medicine PLLC · Henderson, TX
Active · expires Apr 13, 2028
CLIA Number45D2006203
Laboratory TypePhysician Office
Certificate Effective DateApril 14, 2026
Certificate Expiration DateApril 13, 2028
Laboratory DirectorTad Titlow
Laboratory Phone(903) 235-0086
Laboratory LocationHenderson Family Medicine PLLC105 N High St, Henderson, TX 75652
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Henderson Family Medicine, PLLC's NPI number?

The NPI number for Henderson Family Medicine, PLLC is 1831415793. It was assigned to this organization in the NPPES registry on April 15, 2010.

Where is Henderson Family Medicine, PLLC located?

Henderson Family Medicine, PLLC is located at 105 N High St, Henderson, TX 75652. The listed phone number is (903) 235-0086.

What is Henderson Family Medicine, PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Henderson Family Medicine, PLLC enrolled in Medicare?

Yes. Henderson Family Medicine, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Henderson Family Medicine, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Henderson Family Medicine, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Internal Medicine (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Henderson Family Medicine, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2006203) is associated with this NPI, valid through April 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Henderson Family Medicine, PLLC was last updated on April 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.