Provider Demographics
NPI:1225066913
Name:HAYES, LORRIE B (MD)
Entity Type:Individual
Prefix:DR
First Name:LORRIE
Middle Name:B
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5408 COLLEYVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5833
Mailing Address - Country:US
Mailing Address - Phone:817-498-9920
Mailing Address - Fax:817-498-0635
Practice Address - Street 1:5408 COLLEYVILLE BLVD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5833
Practice Address - Country:US
Practice Address - Phone:817-498-9920
Practice Address - Fax:817-498-0635
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2311207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B5304OtherBCBSTX
TX150703001Medicaid
TX8B5304OtherBCBSTX
TX150703001Medicaid