Doctor Name: | CHARLENE HAYNES |
NPI Number: | 1154466449 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OD |
License Number: | 4268TG |
Business Practice Address: | 16793 San Pedro Ave San Antonio, TX - 782322349 |
Business Phone Number: | 2105454772 |
Business Fax Number: | 2105455350 |
Mailing Address: | 16793 San Pedro Ave, SAN ANTONIO |
State: | TX |
Postal Code: | 782322349 |
Phone Number: | 2105454772 |
Fax Number: | 2105455350 |
NPI Enumeration Date: | 02/21/2007 |
NPI Last Update Date: | 12/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 4268TG |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |