Provider Demographics
NPI:1568062818
Name:ALFORD, HAILEY ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:HAILEY
Middle Name:ELIZABETH
Last Name:ALFORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 S 3RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75147-2727
Mailing Address - Country:US
Mailing Address - Phone:903-887-1073
Mailing Address - Fax:
Practice Address - Street 1:604 S 3RD ST STE A
Practice Address - Street 2:
Practice Address - City:MABANK
Practice Address - State:TX
Practice Address - Zip Code:75147-2727
Practice Address - Country:US
Practice Address - Phone:903-887-1073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13758363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant