Provider Demographics
NPI:1083817688
Name:PEIFFER, NICHOLAS JAMES (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:JAMES
Last Name:PEIFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10740 N GESSNER RD STE 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:281-897-0416
Mailing Address - Fax:800-876-1456
Practice Address - Street 1:4401 COIT RD
Practice Address - Street 2:SUITE 411
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0500
Practice Address - Country:US
Practice Address - Phone:972-731-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-09
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8915207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M7403OtherBLUE CROSS BLUE SHIELD
BP2-0026683OtherINSTITUTIONAL PERMIT