Provider Demographics
NPI:1245112853
Name:PAYTON CHAMBERS, SHAVONNA MARIA
Entity type:Individual
Prefix:
First Name:SHAVONNA
Middle Name:MARIA
Last Name:PAYTON CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2656 REDCEDAR DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6604
Mailing Address - Country:US
Mailing Address - Phone:469-215-4742
Mailing Address - Fax:
Practice Address - Street 1:2656 REDCEDAR DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6604
Practice Address - Country:US
Practice Address - Phone:469-215-4742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program