Provider Demographics
NPI:1255076733
Name:PAYTON, MARCUS (QMHP-CS)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:PAYTON
Suffix:
Gender:M
Credentials:QMHP-CS
Other - Prefix:
Other - First Name:MARCUS
Other - Middle Name:
Other - Last Name:PAYTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:QMHP-CS
Mailing Address - Street 1:1628 RIDGE HAVEN DR APT 810
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-9043
Mailing Address - Country:US
Mailing Address - Phone:225-303-3166
Mailing Address - Fax:
Practice Address - Street 1:1628 RIDGE HAVEN DR APT 810
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-9043
Practice Address - Country:US
Practice Address - Phone:225-303-3166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator