Provider Demographics
NPI:1619906534
Name:PAY, TERI A (NP)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:A
Last Name:PAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 N CREST RD
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-2798
Mailing Address - Country:US
Mailing Address - Phone:806-662-3613
Mailing Address - Fax:
Practice Address - Street 1:701 N PRICE RD
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-5126
Practice Address - Country:US
Practice Address - Phone:806-688-2273
Practice Address - Fax:806-665-0537
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45736363L00000X
TX739475207P00000X, 363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX201311203Medicaid
OK200308720 AMedicaid
KS200347480CMedicaid
TX201311202Medicaid
KS161690OtherBCBS
NM01409751Medicaid
KS161690OtherBCBS
TX201311203Medicaid
TX201311202Medicaid