Provider Demographics
NPI:1811188097
Name:HAVEMANN, ERIC CONRAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CONRAD
Last Name:HAVEMANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:906 W MCDERMOTT DR # 116-371
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6510
Mailing Address - Country:US
Mailing Address - Phone:469-541-1600
Mailing Address - Fax:469-541-1612
Practice Address - Street 1:4510 MEDICAL CENTER DR STE 211
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1602
Practice Address - Country:US
Practice Address - Phone:469-541-1600
Practice Address - Fax:469-541-1612
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP1-0028920207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4660532462OtherMYUTMB 4660532462