Basic Information
| Provider Information | |||||||||
| NPI: | 1942664453 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREEN | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | HAYES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 515 W MAYFIELD RD STE 118 | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760142084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8773148990 | ||||||||
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| Practice Location | |||||||||
| Address1: | 515 W MAYFIELD RD STE 118 | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760142084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8773148990 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2016 | ||||||||
| LastUpdateDate: | 09/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | T0082 | TX | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0801X | T0082 | TX | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
No ID Information.