Healthcare Provider Details

I. General information

NPI: 1538486188
Provider Name (Legal Business Name): PETER Y TIEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2010
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025 FRY RD STE 200
CYPRESS TX
77433-8152
US

IV. Provider business mailing address

7025 FRY RD STE 200
CYPRESS TX
77433-8152
US

V. Phone/Fax

Practice location:
  • Phone: 832-975-7288
  • Fax:
Mailing address:
  • Phone: 832-975-7288
  • Fax: 832-975-7287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA123596
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR0512
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number303174
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: