MEDICARE: PAYDEN MORGAN LAND MPAS, PA-C

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	363A00000X	Physician Assistant	PA13455	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851951180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAYDEN MORGAN LAND MPAS, PA-C

Provider Business Mailing Address
First Line	:	399 REID RD
Second Line	:
City	:	JUNCTION
State	:	TX
Zip	:	76849-3049
Country	:	US
Telephone Number	:	325-446-3305
Fax Number	:	325-446-3990

Provider Business Practice Location Address
First Line	:	399 REID RD
Second Line	:
City	:	JUNCTION
State	:	TX
Zip	:	76849-3049
Country	:	US
Telephone Number	:	325-446-3305
Fax Number	:	325-446-3990

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

Provider Enumeration Date	:	06/18/2019
Last Update Date	:	04/17/2024

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