Provider Demographics
NPI:1477528875
Name:HAYTER, PAUL G (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:G
Last Name:HAYTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3341 REGENT BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3131
Mailing Address - Country:US
Mailing Address - Phone:972-910-8829
Mailing Address - Fax:
Practice Address - Street 1:3341 REGENT BLVD STE 120
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3131
Practice Address - Country:US
Practice Address - Phone:972-910-8829
Practice Address - Fax:972-910-8778
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005617TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist