Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | S5641 | TX |
Y | 207RX0202X | Medical Oncology | S5649 | TX |
NPI | 1023437290 |
---|---|
Provider Name | Pamela Paige Hayes |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75230-2571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 20/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
418022601 | (05) | TX |