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General NPI Number Information
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NPI Number | 1932318763
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Entity Type | Individual
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Provider Name | TIMOTHY FRANKLIN HAYNES P.A.-C.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1560 W BAY AREA BLVD SUITE 280
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-2667
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Country | US
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Telephone | 281-990-8200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1200
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City | CRYSTAL BEACH
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State | TX
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Zip | 77650-1200
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Country | US
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Telephone | 409-684-1020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01670
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License Number State | TX
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