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NPI Code Detail

MEDICARE: MARCUS PAYTON QMHP-CS

MEDICARE:   MARCUS  PAYTON  QMHP-CS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1255076733
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUS PAYTON QMHP-CS
Provider Business Mailing Address
First Line : 1628 RIDGE HAVEN DR APT 810
Second Line :
City : ARLINGTON
State : TX
Zip : 76011-9043
Country : US
Telephone Number : 225-303-3166
Fax Number :
Provider Business Practice Location Address
First Line : 1628 RIDGE HAVEN DR APT 810
Second Line :
City : ARLINGTON
State : TX
Zip : 76011-9043
Country : US
Telephone Number : 225-303-3166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2022
Last Update Date : 04/30/2022

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Directions to “ MARCUS PAYTON QMHP-CS” Practice Location

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