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Individual

WILLIAM DAVID PAYNE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 MEDICAL PKWY, LAKEWAY, TX 78738-5621
(512) 571-5000
(512) 571-5198
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
22988
MS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
N2721
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
216980702
TX
05
216980703
TX
01
8DT795
BLUE CROSS BLUE SHIELD
TX
01
8DT796
BLUE CROSS BLUE SHIELD
TX
01
P01217751
RAILROAD MEDICARE
01
P01217758
RAILROAD MEDICARE
Enumeration date
06/14/2010
Last updated
01/06/2021
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