Peck, Johnnie
Peck, Johnnie is an individual health care provider with primary practice located at 24624 Interstate 45 N #200, Spring TX 77386-4084. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Peck, Johnnie can be contacted via phone (832) 799-4954.Contact Information
Primary practice address
24624 Interstate 45 N #200
Spring TX 77386-4084
Phone: (832) 799-4954
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1467993378 |
|---|---|
| LBN Legal business name | Peck, Johnnie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 10th, 2017 |
| Last updated | Mar 10th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467993378 | NPPES |
| Texas | MEDICAID | 05115620 |
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