Individual provider Active NPI

Howard H Haysom, M.D.

  • Emergency Medicine Physician
  • Pasadena, TX
National Provider Identifier
1659357283
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E9689 Issued in TX
Practice address
4000 Spencer Hwy
Pasadena, TX 77504-1202
Phone
(713) 359-2000
Fax
(713) 359-1004
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E9689 TX Primary

Addresses

Primary practice location

4000 Spencer Hwy
Pasadena, TX 77504-1202

Mailing address

PO Box 200993
Houston, TX 77216-0993
Phone (281) 784-1111

Other identifiers 1

IdentifierTypeStateIssuer
8F8316OtherTXBCBSTX PROV NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090113000853 TN Practitioner - Emergency Medicine 4183707730 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E9689TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Dec 1, 2008 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Sep 19, 2018 Accepting new patients
Greater Houston Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

8045 Roane Medical Center Dr
Harriman, TN 37748
Phone (865) 316-1000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1659357283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200993",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772160993",
            "telephone_number": "281-784-1111",
            "fax_number": "281-784-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 SPENCER HWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041202",
            "telephone_number": "713-359-2000",
            "fax_number": "713-359-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYSOM",
        "first_name": "HOWARD",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "E9689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX PROV NO",
            "identifier": "8F8316",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.