Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | M8915 | TX |
NPI | 1083817688 |
---|---|
Provider Name | Nicholas James Peiffer |
First Address | Frisco, TX 75035-0500 |
Second Address | Frisco, TX 75035-0500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2007 |
Last Update Date | 19/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8M7403 | BLUE CROSS BLUE SHIELD (01) | TX |
BP2-0026683 | INSTITUTIONAL PERMIT (01) |