=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255331435
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES P. HAY PNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2005
-----------------------------------------------------
Last Update Date | 08/30/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1710 W HIGHWAY 287 BUSINESS STE 100
-----------------------------------------------------
City | WAXAHACHIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75165-4733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-937-1221
-----------------------------------------------------
Fax | 972-937-8934
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3148 FM 66
-----------------------------------------------------
City | WAXAHACHIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75167-8406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-935-1302
-----------------------------------------------------
Fax | 972-935-1302
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 551381
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------