Healthcare Provider Details

I. General information

NPI: 1033920574
Provider Name (Legal Business Name): WILLIAM N PEYER SR. R N CC M
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BILL PEYER RN CCM

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10651 E ST BLDG 100
CORPUS CHRISTI TX
78419-5130
US

IV. Provider business mailing address

2217 IVY DR
CORPUS CHRISTI TX
78418-3631
US

V. Phone/Fax

Practice location:
  • Phone: 361-961-6000
  • Fax: 361-961-3501
Mailing address:
  • Phone: 361-939-9392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number522387
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number522387
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: