Provider Demographics
NPI:1073629762
Name:SHAWN A HAYDEN MD PA
Entity Type:Organization
Organization Name:SHAWN A HAYDEN MD PA
Other - Org Name:ONTO ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:214-731-3008
Mailing Address - Street 1:PO BOX 260963
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-0963
Mailing Address - Country:US
Mailing Address - Phone:214-731-3008
Mailing Address - Fax:214-731-3015
Practice Address - Street 1:5509 PLEASANT VALLEY DR STE 700
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5225
Practice Address - Country:US
Practice Address - Phone:214-731-3008
Practice Address - Fax:972-608-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6421174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162365401Medicaid
TX162365401Medicaid
TXH38615Medicare UPIN