Allen V Havener, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

L2308 Issued in TX

Practice address

5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766

Phone

(903) 614-3000

Fax

(903) 614-3525

NPI assigned

Jul 28, 2005

Last updated

Apr 8, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Collom & Carney Clinic Association

  • Cardiovascular Disease Physician
  • Texarkana, TX
  • NPI 1013252279
  NPD
• Collom & Carney Clinic Association

  • Clinical Medical Laboratory
  • Texarkana, TX
  • NPI 1164405296
  NPD
• Collom & Carney Clinic Association

  • Pain Medicine (Anesthesiology) Physician
  • Texarkana, TX
  • NPI 1962829747
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1578563987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 COWHORN CREEK RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755039766",
            "telephone_number": "903-614-3000",
            "fax_number": "903-614-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 COWHORN CREEK RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755039766",
            "telephone_number": "903-614-3000",
            "fax_number": "903-614-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENER",
        "first_name": "ALLEN",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L2308",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E3287",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147224301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145127001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glen Woodford Hart II, O.D.
• Cynthia Hash
• Mary Laura Hastings, DMD
• Hatel Sanjay Patel PA
• Savannah Layne Terry Hatfield, COTA
• Megan Hawley
• Bess C Hawthorne, COTA
• Jamie Danielle Hawthorne, RN
• Robin Hawthorne
• Hayden H Franks MD PA

• Diagnostic Radiology Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.