Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | AP119466 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP119466 | TX |
NPI | 1023310596 |
---|---|
Provider Name | Henrietta J Peynado |
First Address | Pharr, TX 78577-1614 |
Second Address | Edinburg, TX 78539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2010 |
Last Update Date | 28/05/2020 |