Individual
DEMITRA STEPHENS HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18116 FLATHEAD DR, MANOR, TX 78653
(512) 350-2845
Mailing address
18116 FLATHEAD DR, MANOR, TX 78653-4676
(254) 722-5061
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
NA8481034
TX
Other
Enumeration date
09/16/2014
Last updated
04/09/2015
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