Provider Demographics
NPI:1114938958
Name:HAINES, RICHARD H (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:H
Last Name:HAINES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13333 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3581
Mailing Address - Country:US
Mailing Address - Phone:281-242-3333
Mailing Address - Fax:
Practice Address - Street 1:1939 COUNTRY CLUB BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3909
Practice Address - Country:US
Practice Address - Phone:281-491-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9437122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX741694160OtherTIN