Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1253926 | TX |
N | 2251C2600X | Cardiopulmonary | 1253926 | TX |
N | 2251E1200X | Ergonomics | 1253926 | TX |
N | 225XE1200X | Ergonomics | 1253926 | TX |
N | 2251E1300X | Electrophysiology, Clinical | 1253926 | TX |
N | 2251G0304X | Physical Therapist - Geriatrics | 1253926 | TX |
N | 2251H1200X | Hand | 1253926 | TX |
N | 2251H1300X | Human Factors | 1253926 | TX |
N | 225XH1300X | Human Factors | 1253926 | TX |
N | 2251N0400X | Physical Therapist - Neurology | 1253926 | TX |
N | 2251P0200X | Physical Therapist - Pediatrics | 1253926 | TX |
N | 2251S0007X | Physical Therapist - Sports | 1253926 | TX |
N | 2251X0800X | Physical Therapist - Orthopedic | 1253926 | TX |
NPI | 1134691504 |
---|---|
Provider Name | Dr. Matthew Douglas Peacock |
First Address | Hubbard, TX 76648 |
Second Address | Hillsboro, TX 76645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2018 |
Last Update Date | 02/01/2019 |