Healthcare Provider Details

I. General information

NPI: 1689878340
Provider Name (Legal Business Name): BRIAN JOHN PEART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18951 N MEMORIAL DR
HUMBLE TX
77338-4217
US

IV. Provider business mailing address

2202 RIVA ROW APT 4205
THE WOODLANDS TX
77380-3146
US

V. Phone/Fax

Practice location:
  • Phone: 281-540-7700
  • Fax:
Mailing address:
  • Phone: 832-458-2645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberN6574
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: