Active NPI
Willie Bobby Payne Jr., PHARMD
- Pharmacist
- Irving, TX
National Provider Identifier
1013550656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 49083
- Practice address
- 2001 W John Carpenter Fwy
Irving, TX 75063-3255 - Phone
- (800) 379-0092
- NPI assigned
- Oct 27, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 49083 | TX | Primary |
Addresses
Primary practice location
2001 W John Carpenter Fwy
Irving, TX 75063-3255
Mailing address
11450 US Hwy 380 Ste 130 #222
Crossroads, TX 76227-8322
Phone (800) 379-0092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49083 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682726400000",
"number": "1013550656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11450 US HWY 380 STE 130 #222",
"city": "CROSSROADS",
"state": "TX",
"postal_code": "762278322",
"telephone_number": "800-379-0092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 W JOHN CARPENTER FWY",
"city": "IRVING",
"state": "TX",
"postal_code": "750633255",
"telephone_number": "800-379-0092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "WILLIE",
"middle_name": "BOBBY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-27",
"last_updated": "2023-04-29",
"certification_date": "2023-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "49083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.