MEDICARE: DR. MARC DANIEL PECHA M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	K2095	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	:	1518960442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC DANIEL PECHA M.D.

Provider Business Mailing Address
First Line	:	2701 BABCOCK RD
Second Line	:	STE A
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4866
Country	:	US
Telephone Number	:	210-614-3225
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 BABCOCK RD
Second Line	:	STE A
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4866
Country	:	US
Telephone Number	:	210-614-3225
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/21/2009

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