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General NPI Number Information
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NPI Number | 1114116233
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Entity Type | Organization
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Legal Business Name | BONE EXPRESS PLLC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 3108 MIDWAY RD SUITE 104
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City | PLANO
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State | TX
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Zip | 75093-6383
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Country | US
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Telephone | 214-731-3008
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Fax | 214-731-3015
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Provider Business Mailing Address
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Address Line | PO BOX 262348
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City | PLANO
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State | TX
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Zip | 75026-2348
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Country | US
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Telephone | 214-731-3008
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Fax | 214-731-3015
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. SHAWN A. HAYDEN
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Credential | M.D.
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Telephone | 214-731-3008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | L6421
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License Number State | TX
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