Healthcare Provider Details

I. General information

NPI: 1558029389
Provider Name (Legal Business Name): PEKS MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5802 EDEN CREST CT
RICHMOND TX
77407-1617
US

IV. Provider business mailing address

5802 EDEN CREST CT
RICHMOND TX
77407-1617
US

V. Phone/Fax

Practice location:
  • Phone: 281-975-8819
  • Fax:
Mailing address:
  • Phone: 281-975-8819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: EUNICE KOFFI
Title or Position: OWNER
Credential: NP
Phone: 281-975-8819