Provider Demographics
NPI:1861471724
Name:HAYMES, DAVID ANDERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANDERSON
Last Name:HAYMES
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 1:12830 HILLCREST RD
Mailing Address - Street 2:D 216
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1527
Mailing Address - Country:US
Mailing Address - Phone:972-233-5651
Mailing Address - Fax:972-233-0960
Practice Address - Street 1:12830 HILLCREST RD
Practice Address - Street 2:D 216
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1527
Practice Address - Country:US
Practice Address - Phone:972-233-5651
Practice Address - Fax:972-233-0960
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3258207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP086Z2214Medicaid
TX86Z221Medicare ID - Type Unspecified
TXP086Z2214Medicaid