Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | P9935 | TX |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | P9935 | TX |
NPI | 1275720427 |
---|---|
Provider Name | Judith Tombobi Peyechu |
First Address | Conroe, TX 77385-1119 |
Second Address | Humble, TX 77338-4547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2007 |
Last Update Date | 24/06/2015 |