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NPI Code Detail

MEDICARE: PEGGY JEANINE BOINEAU

MEDICARE: PEGGY JEANINE BOINEAU
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
1225XH1200XHand Occupational Therapist108070TX

General Provider Information

NPI Number : 1598981458
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEGGY JEANINE BOINEAU
Provider Business Mailing Address
First Line : 305 FREEMAN BLVD
Second Line :
City : WEST COLUMBIA
State : TX
Zip : 77486-9667
Country : US
Telephone Number : 979-345-6313
Fax Number :
Provider Business Practice Location Address
First Line : 305 N MCKINNEY ST
Second Line :
City : SWEENY
State : TX
Zip : 77480-2801
Country : US
Telephone Number : 979-798-9190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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Directions to “ PEGGY JEANINE BOINEAU ” Practice Location

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