Provider Demographics
NPI:1114116233
Name:BONE EXPRESS PLLC
Entity Type:Organization
Organization Name:BONE EXPRESS PLLC
Other - Org Name:BONE EXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
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
Authorized Official - Phone:214-731-3008
Mailing Address - Street 1:PO BOX 262348
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-2348
Mailing Address - Country:US
Mailing Address - Phone:214-731-3008
Mailing Address - Fax:214-731-3015
Practice Address - Street 1:3108 MIDWAY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6383
Practice Address - Country:US
Practice Address - Phone:214-731-3008
Practice Address - Fax:214-731-3015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6421207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty