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Individual
MR. THEODORE DAVID HAYNES JR.
Active
Individual
MR. THEODORE DAVID HAYNES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
549839
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86602U
BCBSTX
TX
Enumeration date
02/15/2006
Last updated
11/19/2007
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