MEDICARE: BRYCE HAYES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171WV0202X	Vehicle Modifications Contractor
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	332BC3200X	Customized Equipment (DME)
4	171WH0202X	Home Modifications Contractor

General Provider Information

NPI Number	:	1063251635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYCE HAYES

Provider Business Mailing Address
First Line	:	16568 KINGSTON CT
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-7338
Country	:	US
Telephone Number	:	903-617-8800
Fax Number	:	903-630-2402

Provider Business Practice Location Address
First Line	:	16568 KINGSTON CT
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-7338
Country	:	US
Telephone Number	:	903-617-8800
Fax Number	:	903-630-2402

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BRYCE EDWARDS HAYES
Credential	:
Telephone Number	:	903-617-8800

Provider Enumeration Date	:	05/22/2024
Last Update Date	:	05/09/2025

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305 S BROADWAY AVE STE 603
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Directions to “BRYCE HAYES ” Practice Location

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