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NPI 1366424368

NPI 1366424368 : PEGGY A BURPEE DO : SAN ANGELO, TX

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General NPI Number Information
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    NPI Number           |    1366424368
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    Entity Type          |    Individual 
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    Provider Name        |    PEGGY A BURPEE DO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/16/2005
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    Last Update Date     |    03/02/2021
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Provider Practice Location Address
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    Address Line         |    4235 SOUTHWEST BLVD 
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    City                 |    SAN ANGELO
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    State                |    TX
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    Zip                  |    76904-5635
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    Country              |    US
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    Telephone            |    325-658-9151
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    Fax                  |    325-481-2166
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Provider Business Mailing Address
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    Address Line         |    PO BOX 22000 
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    City                 |    SAN ANGELO
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    State                |    TX
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    Zip                  |    76902-7200
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    Country              |    US
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    Telephone            |    325-747-3408
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    Fax                  |    325-747-2525
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    L7431
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    License Number State |    TX
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