Provider Demographics
NPI:1033595301
Name:PAYTON, ENRYKA DANIELLE
Entity Type:Individual
Prefix:
First Name:ENRYKA
Middle Name:DANIELLE
Last Name:PAYTON
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 1:12680 W LAKE HOUSTON PKWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-6087
Mailing Address - Country:US
Mailing Address - Phone:281-439-0987
Mailing Address - Fax:
Practice Address - Street 1:12680 W LAKE HOUSTON PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-6087
Practice Address - Country:US
Practice Address - Phone:281-439-0987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist