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General NPI Number Information
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NPI Number | 1528207024
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Entity Type | Organization
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Legal Business Name | STEVEN P HAVARD, MD, PA
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Dates
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Enumeration Date | 02/07/2009
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 1759 BROAD PARK CIR S SUITE 201
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City | MANSFIELD
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State | TX
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Zip | 76063-7833
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Country | US
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Telephone | 817-225-2718
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Fax | 817-225-2771
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Provider Business Mailing Address
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Address Line | 1759 BROAD PARK CIR S SUITE 201
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City | MANSFIELD
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State | TX
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Zip | 76063-7833
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Country | US
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Telephone | 817-225-2718
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Fax | 817-225-2771
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | ATHENNA HAVARD
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Credential | RN
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Telephone | 817-225-2718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | L9235
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License Number State | TX
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