Provider Demographics
NPI:1063524098
Name:JAMES A HALEY M.D. P.A.
Entity type:Organization
Organization Name:JAMES A HALEY M.D. P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-382-0900
Mailing Address - Street 1:2817 S MAYHILL RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5966
Mailing Address - Country:US
Mailing Address - Phone:940-382-0900
Mailing Address - Fax:940-565-9969
Practice Address - Street 1:2817 S MAYHILL RD
Practice Address - Street 2:SUITE 120
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-5966
Practice Address - Country:US
Practice Address - Phone:940-382-0900
Practice Address - Fax:940-565-9969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9087174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A2930OtherBC/BS
TX1831168632OtherNPI
TX033193601Medicaid
TX00W875Medicare PIN
TX033193601Medicaid