Provider Demographics
NPI:1316585771
Name:PAYTONJIAN, LINDA J (NNP - BC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:J
Last Name:PAYTONJIAN
Suffix:
Gender:F
Credentials:NNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 W AURORA VISTA TRL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:TX
Mailing Address - Zip Code:76078-4645
Mailing Address - Country:US
Mailing Address - Phone:817-657-4546
Mailing Address - Fax:817-489-2694
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-242-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144392363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care