Provider Demographics
NPI:1134390693
Name:HAYNES, DAWSHEEN TRA' SHAWN (DC)
Entity type:Individual
Prefix:DR
First Name:DAWSHEEN
Middle Name:TRA' SHAWN
Last Name:HAYNES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 N SAGINAW BLVD STE F10
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1100
Mailing Address - Country:US
Mailing Address - Phone:817-710-4220
Mailing Address - Fax:817-719-9318
Practice Address - Street 1:1029 N SAGINAW BLVD STE F10
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1100
Practice Address - Country:US
Practice Address - Phone:817-710-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX618324Medicare PIN