Basic Information
Provider Information | |||||||||
NPI: | 1992935597 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HAYES | ||||||||
FirstName: | PATRICIA | ||||||||
MiddleName: | MELO | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3427 BROADMEAD DR | ||||||||
Address2: |   | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770253702 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8327465683 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 5104 HARRISBURG BLVD STE 800 | ||||||||
Address2: |   | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770110001 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8326674150 | ||||||||
FaxNumber: | 8338539420 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/17/2009 | ||||||||
LastUpdateDate: | 04/16/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 04/16/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | BP10034547 | TX | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 207R00000X | P5639 | TX | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | BP10034547 | TX | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
No ID Information.