Provider Demographics
NPI:1215911524
Name:PAYNE, FRANK CORRY III (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:CORRY
Last Name:PAYNE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:F
Other - Middle Name:CORRY
Other - Last Name:PAYNE
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7115 GREENVILLE AVENUE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-265-3200
Mailing Address - Fax:214-265-3292
Practice Address - Street 1:7115 GREENVILLE AVENUE
Practice Address - Street 2:SUITE 310
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-265-3200
Practice Address - Fax:214-265-3292
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4359204C00000X, 207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BZ907OtherBCBS
TX752130698OtherTAX ID
TX035484702Medicaid
TXC20325Medicare UPIN
TXP00771587Medicare PIN
TX8L13591Medicare PIN