Provider Demographics
NPI:1316503980
Name:PEYTON, DARRIUS MONTRE (COTA/L)
Entity type:Individual
Prefix:
First Name:DARRIUS
Middle Name:MONTRE
Last Name:PEYTON
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7373 VALLEY VIEW LN APT 1109
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5576
Mailing Address - Country:US
Mailing Address - Phone:214-400-2668
Mailing Address - Fax:
Practice Address - Street 1:824 W MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3647
Practice Address - Country:US
Practice Address - Phone:817-465-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-19
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213252224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant