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Organization

CHARLENE L. HAYNES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLENE L HAYNES OD, FAAO (OWNER)
(210) 545-4772
Entity
Organization

Contact information

Practice address
16793 SAN PEDRO AVE, SAN ANTONIO, TX 78232-2349
(210) 545-4772
(210) 545-5350
Mailing address
16793 SAN PEDRO AVE, SAN ANTONIO, TX 78232-2349
(210) 545-4772
(210) 545-5350

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
04268TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1154466449
MEDICARE NPI
TX
Enumeration date
06/08/2011
Last updated
10/25/2011
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