Provider Demographics
NPI:1326887159
Name:GOWDY, PAYTON BRIANNE
Entity type:Individual
Prefix:MRS
First Name:PAYTON
Middle Name:BRIANNE
Last Name:GOWDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S TAYLOR ST UNIT 222
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-2445
Mailing Address - Country:US
Mailing Address - Phone:806-316-5595
Mailing Address - Fax:
Practice Address - Street 1:500 S TAYLOR ST STE 600
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-2458
Practice Address - Country:US
Practice Address - Phone:806-316-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health