Provider Demographics
NPI:1265474589
Name:LINGUIST, PEGGY FENTON (MD)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:FENTON
Last Name:LINGUIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-3827
Mailing Address - Country:US
Mailing Address - Phone:972-923-2440
Mailing Address - Fax:972-923-2445
Practice Address - Street 1:411 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-3827
Practice Address - Country:US
Practice Address - Phone:972-923-2440
Practice Address - Fax:972-923-2445
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3788208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046524703Medicaid
TX1326236464Medicaid
TX0465247-02Medicaid
TX0465247-01Medicaid
TX1326236464Medicaid
TXG50730Medicare UPIN
TX0465247-01Medicaid