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NPI Code Detail

MEDICARE: LEE PAYNE

MEDICARE: LEE PAYNE
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11134450OTHERTXLICENSE

General Provider Information

NPI Number : 1154430726
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE PAYNE
Provider Business Mailing Address
First Line : 5821 CHARLOTTE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77005-2413
Country : US
Telephone Number : 713-743-6247
Fax Number :
Provider Business Practice Location Address
First Line : 2158 PORTSMOUTH ST
Second Line :
City : HOUSTON
State : TX
Zip : 77098-4057
Country : US
Telephone Number : 713-529-4990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/08/2007

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Directions to “ LEE PAYNE ” Practice Location

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