Provider Demographics
NPI:1891755138
Name:HASKINS, TONY (MD)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:
Last Name:HASKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710A NE STALLINGS DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1615
Mailing Address - Country:US
Mailing Address - Phone:936-560-1110
Mailing Address - Fax:936-560-4567
Practice Address - Street 1:4710A NE STALLINGS DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1615
Practice Address - Country:US
Practice Address - Phone:936-560-1110
Practice Address - Fax:936-560-4567
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4053207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036233701Medicaid
TX00TW35Medicare ID - Type Unspecified
TX036233701Medicaid