Provider Demographics
NPI:1316288780
Name:PAYNE, CYNTHIA (RPH)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S CAPITAL OF TEXAS HWY
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5243
Mailing Address - Country:US
Mailing Address - Phone:512-329-5184
Mailing Address - Fax:
Practice Address - Street 1:701 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5243
Practice Address - Country:US
Practice Address - Phone:512-329-5184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25922183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist