Provider Demographics
NPI:1144576224
Name:HAYNES, TREVOR J (DPM)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:J
Last Name:HAYNES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 BRONZE LOQUATE CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-5668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:37569 HIGHWAY 26
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-9301
Practice Address - Country:US
Practice Address - Phone:503-668-5210
Practice Address - Fax:877-480-9759
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP185979213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery