Organization Active NPI

Robert F. Haynsworth Jr., PA

  • Pain Medicine Physician
  • Plano, TX
National Provider Identifier
1366755787
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
F9544 Issued in TX
Legal business name
ROBERT F. HAYNSWORTH JR., PA
Practice address
4708 Alliance Blvd Ste 810
Plano, TX 75093-5338
Phone
(469) 814-5960
Fax
(469) 814-5969
NPI assigned
Jul 15, 2010
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert F Haynsworth Jr., MDNPI 1528046414
Title
President
Phone
(469) 814-5960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X F9544 TX Primary

Addresses

Primary practice location

4708 Alliance Blvd Ste 810
Plano, TX 75093-5338

Mailing address

4708 Alliance Blvd Ste 810
Plano, TX 75093-5338
Phone (469) 814-5960

Other identifiers 1

IdentifierTypeStateIssuer
033600001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100726000414 TX Part B Supplier - Clinic/Group Practice 1658403738 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1366755787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD STE 810",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935338",
            "telephone_number": "469-814-5960",
            "fax_number": "972-767-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD STE 810",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935338",
            "telephone_number": "469-814-5960",
            "fax_number": "469-814-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT F. HAYNSWORTH JR., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "HAYNSWORTH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-814-5960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "F9544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033600001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.