Basic Information
| Provider Information | |||||||||
| NPI: | 1609532944 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ATTARD | ||||||||
| FirstName: | PAYTON | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10219 LOST PATH LN | ||||||||
| Address2: | |||||||||
| City: | MAGNOLIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773544107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817276954 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6410 FANNIN ST STE 350 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770303004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322357133 | ||||||||
| FaxNumber: | 7133831479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2021 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA14948 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.