Provider Demographics
NPI:1629793971
Name:HAYES, TONYA HOPE
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:HOPE
Last Name:HAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2688 CALDER ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1917
Mailing Address - Country:US
Mailing Address - Phone:409-813-2206
Mailing Address - Fax:409-813-2236
Practice Address - Street 1:2688 CALDER ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1917
Practice Address - Country:US
Practice Address - Phone:140-981-3220
Practice Address - Fax:409-813-2236
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX04-3774985Medicaid