Provider Demographics
NPI:1427042340
Name:HAYNES, WILLIAM A (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:HAYNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9611 ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:TX
Mailing Address - Zip Code:76226-6426
Mailing Address - Country:US
Mailing Address - Phone:940-725-0022
Mailing Address - Fax:
Practice Address - Street 1:9611 ARBOR CT
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:TX
Practice Address - Zip Code:76226-6426
Practice Address - Country:US
Practice Address - Phone:940-725-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2010-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3116207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130479209Medicaid
8U3588OtherBCBS
8U3588OtherBCBS
E84181Medicare UPIN