Provider Demographics
NPI:1225795396
Name:PEAK PRIMARY CARE
Entity Type:Organization
Organization Name:PEAK PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHAC
Authorized Official - Suffix:
Authorized Official - Credentials:AGNP-BC
Authorized Official - Phone:713-589-3775
Mailing Address - Street 1:2039 NORTH MASON ROAD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7971
Mailing Address - Country:US
Mailing Address - Phone:713-315-7427
Mailing Address - Fax:
Practice Address - Street 1:2039 N. MASON ROAD
Practice Address - Street 2:SUITE 601
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449
Practice Address - Country:US
Practice Address - Phone:281-665-9296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care