| Doctor Name: | DEMITRA STEPHENS HAYNES |
| NPI Number: | 1023410560 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | NA8481034 |
| Business Practice Address: | 18116 Flathead Dr Manor, TX - 78653 |
| Business Phone Number: | 5123502845 |
| Business Fax Number: | |
| Mailing Address: | 18116 Flathead Dr, MANOR |
| State: | TX |
| Postal Code: | 786534676 |
| Phone Number: | 2547225061 |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2014 |
| NPI Last Update Date: | 04/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | NA8481034 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |