Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Raven Henderson, MD

Individual provider Plastic Surgery Physician · NPI 1437415726

Raven Henderson, MD is a Plastic Surgery Physician in Tyler, Texas. Licensed in Kansas. Registered with an NPI since 2012.

Licensed in
KS
In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2140 W Grande Blvd Ste A
Tyler, TX 75703-0563
Phone: (903) 251-2765
Fax: (270) 216-6827
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 04-40363 (KS)

Record details

NPI number1437415726
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 11, 2012
Last updated in NPPESJuly 5, 2024
Certification dateJuly 5, 2024
Mailing address2140 W Grande Blvd Ste A, Tyler, TX 75703-0563

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