Provider Demographics
NPI:1235582370
Name:HAYLEY EYE CLINIC PC
Entity Type:Organization
Organization Name:HAYLEY EYE CLINIC PC
Other - Org Name:HAYLEY EYE CLINIC OF VERNON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAYLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:940-723-2020
Mailing Address - Street 1:1901 KEMP BLVD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76309-3959
Mailing Address - Country:US
Mailing Address - Phone:940-723-2020
Mailing Address - Fax:940-723-6941
Practice Address - Street 1:1918 PEASE ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-4608
Practice Address - Country:US
Practice Address - Phone:940-553-4328
Practice Address - Fax:940-553-3701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAYLEY EYE CLINIC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-13
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2530TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty