MEDICARE: PEAK MIDWIFERY AND BIRTHING CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QB0400X	Birthing Clinic/Center	150021	TX

General Provider Information

NPI Number	:	1841559747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK MIDWIFERY AND BIRTHING CENTER

Provider Business Mailing Address
First Line	:	2203 N 16TH ST
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-2430
Country	:	US
Telephone Number	:	409-768-0068
Fax Number	:	337-376-0176

Provider Business Practice Location Address
First Line	:	2203 N 16TH ST
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-2430
Country	:	US
Telephone Number	:	409-768-0068
Fax Number	:	337-376-0176

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. REBECCA SUZANNE PRICE-WOOD
Credential	:	LM, CPM
Telephone Number	:	512-744-3037

Provider Enumeration Date	:	05/11/2012
Last Update Date	:	05/11/2012

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