Henderson, Raven

Henderson, Raven is an individual health care provider with primary practice located at 2140 W Grande Blvd Ste A , Tyler TX 75703-0563. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as her primary health care specialty. Henderson, Raven can be contacted via phone (903) 251-2765.

Contact Information

Primary practice address
2140 W Grande Blvd Ste A Tyler TX 75703-0563
Phone: (903) 251-2765
Fax: (270) 216-6827
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 04-40363 Kansas

Profile Details

NPI number 1437415726
LBN Legal business name Henderson, Raven
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2012
Last updated Jul 5th, 2024 - about 2 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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