MEDICARE: PEIGELYN ANN DORNO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	5263	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427563378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEIGELYN ANN DORNO

Provider Business Mailing Address
First Line	:	6914 BRISBANE CT STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4924
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6914 BRISBANE CT STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4924
Country	:	US
Telephone Number	:	813-374-2070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2017
Last Update Date	:	12/14/2023

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Directions to “ PEIGELYN ANN DORNO ” Practice Location

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