Individual
JORDAN PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 ROSALIND REDFERN GROVER PKWY, MIDLAND, TX 79701-5846
(432) 221-1111
Mailing address
2215 NASHVILLE AVENUE, LUBBOCK, TX 79410
(806) 725-4800
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R2440
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
583266YKT8
MEDICARE
TX
01
—
8HA174
BCBS
TX
Enumeration date
06/12/2014
Last updated
03/17/2018
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