Provider Demographics
NPI:1518367119
Name:PURYEAR, HALEY ELIZABETH (OD)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ELIZABETH
Last Name:PURYEAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 S BROADWAY ST
Mailing Address - Street 2:SUITE 180
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-4922
Mailing Address - Country:US
Mailing Address - Phone:214-987-2875
Mailing Address - Fax:
Practice Address - Street 1:10740 N CENTRAL EXPY
Practice Address - Street 2:SUITE 180
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2161
Practice Address - Country:US
Practice Address - Phone:214-987-2875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8452T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist