Provider Demographics
NPI:1487687323
Name:HAYLEY, JOE C (OD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:C
Last Name:HAYLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:1901 KEMP BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-3959
Practice Address - Country:US
Practice Address - Phone:940-723-2020
Practice Address - Fax:940-723-6941
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2530TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0193591-01Medicaid
TX0193591-01Medicaid
TXE446Medicare ID - Type Unspecified