MEDICARE: PEYTON ALLEN OD

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
1	152W00000X	Optometrist	10886	TX

General Provider Information

NPI Number	:	1518643451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEYTON ALLEN OD

Provider Business Mailing Address
First Line	:	2071 CYPRESS CREEK ROAD
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2071 CYPRESS CREEK ROAD
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613
Country	:	US
Telephone Number	:	512-250-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	06/26/2023

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Directions to “ PEYTON ALLEN OD” Practice Location

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