Healthcare Provider Details
I. General information
NPI: 1265210751
Provider Name (Legal Business Name): PECAN HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2023
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20320 NORTHWEST FWY STE 400A
JERSEY VILLAGE TX
77065-5620
US
IV. Provider business mailing address
PO BOX 39077
BELFAST ME
04915-1232
US
V. Phone/Fax
- Phone: 346-345-2092
- Fax:
- Phone: 346-345-2092
- Fax: 281-883-4395
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1006X |
| Taxonomy | Metabolic Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0000X |
| Taxonomy | Pain Management Registered Nurse |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARCIAL
OQUENDO
Title or Position: OWNER
Credential: MD
Phone: 214-317-5630