Provider Demographics
NPI:1972499895
Name:HAYAT, HODELIA (ABOC, NCLEC)
Entity type:Individual
Prefix:
First Name:HODELIA
Middle Name:
Last Name:HAYAT
Suffix:
Gender:F
Credentials:ABOC, NCLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 WEITZEL ST
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-4416
Mailing Address - Country:US
Mailing Address - Phone:970-221-8510
Mailing Address - Fax:970-221-7148
Practice Address - Street 1:4500 WEITZEL ST
Practice Address - Street 2:
Practice Address - City:TIMNATH
Practice Address - State:CO
Practice Address - Zip Code:80547-4416
Practice Address - Country:US
Practice Address - Phone:970-221-8510
Practice Address - Fax:970-221-7148
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261271156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician