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General NPI Number Information
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NPI Number | 1619641164
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Entity Type | Individual
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Provider Name | BRIAN PEINE MD
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Gender | Male
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Dates
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Enumeration Date | 08/06/2021
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 2401 S 31ST ST
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City | TEMPLE
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State | TX
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Zip | 76508-0001
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Country | US
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Telephone | 254-724-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 5709 FAIR HILL DR
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City | TEMPLE
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State | TX
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Zip | 76502-1951
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Country | US
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Telephone | 283-658-1752
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Fax |
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | BP10088737
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License Number State | TX
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