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Individual

GARY CHARLES PAYNE

Active
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Individual

GARY CHARLES PAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0536
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T800
BCBS
—
05
—
018830201
—
TX
01
—
11011766
AMERIGROUP
—
01
—
4464150001
PALMETTO GBA
—
01
—
480900054
UNITED HEALTH CARE RAIL R
—
01
—
741891053
AETNA
—
01
—
DPM536
CMI WALMART
—
01
—
T15205
COMMERCIAL CARRIERS
—
Enumeration date
08/01/2006
Last updated
06/16/2010
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