Individual
GARY CHARLES PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
12833B RESEARCH BLVD., AUSTIN, TX 78750
(512) 249-2253
(512) 258-2109
Mailing address
12833B RESEARCH BLVD, AUSTIN, TX 78750-3200
(512) 249-2253
(512) 258-2109
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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