Individual
ALLEN V HAVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
E3287
AR
2085R0202X
Diagnostic Radiology Physician
Primary
L2308
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145127001
—
AR
05
—
147224301
—
TX
Enumeration date
07/28/2005
Last updated
04/08/2011
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