Provider Demographics
NPI:1194276410
Name:PAYNTER, ABBY
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:PAYNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:FOURNIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1421 LILAC LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5249
Mailing Address - Country:US
Mailing Address - Phone:401-527-0382
Mailing Address - Fax:
Practice Address - Street 1:1421 LILAC LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5249
Practice Address - Country:US
Practice Address - Phone:401-527-0382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115213225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist