MEDICARE: DR. CHRISTINE PAYNE 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	6728TG	TX

General Provider Information

NPI Number	:	1699964338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE PAYNE OD

Provider Business Mailing Address
First Line	:	6000 W WILLIAM CANNON DR
Second Line	:	BLDG A, STE 100
City	:	AUSTIN
State	:	TX
Zip	:	78749-1975
Country	:	US
Telephone Number	:	512-288-0444
Fax Number	:	512-288-1009

Provider Business Practice Location Address
First Line	:	6000 W WILLIAM CANNON DR
Second Line	:	BLDG A, STE 100
City	:	AUSTIN
State	:	TX
Zip	:	78749-1975
Country	:	US
Telephone Number	:	512-288-0444
Fax Number	:	512-288-1009

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

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	03/07/2011

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