NPI age
14 years
Enumerated 2012-04-11
● Active
Type 1 · Individual
Raven Henderson, M.D.
Henderson is 1 of 9 plastic surgery providers in Tyler and 1 of 618 in Texas.
Primary specialty
Plastic Surgery
Licensed in
KS
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-07-05
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 618 active plastic surgery providers in Texas.
NPI age
14 years
↓ 3 yr below median (17 yr)
State licenses
1 state
9% of peers hold multiple states
Subspecialties
0
24% of peers hold subspecialties
NPI lifetime · 2012 → 2026
2012-04Enumerated in NPPES
2012
2026
Where they practice
Practice location
2140 W Grande Blvd Ste A
Tyler, TX 757030563
Mailing address
2140 W Grande Blvd Ste A
Tyler, TX 757030563
Specialties
-
Plastic Surgery PrimaryA plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.