Provider Demographics
NPI:1275720427
Name:PEYECHU, JUDITH TOMBOBI (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:TOMBOBI
Last Name:PEYECHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8340 GREENLEAF RIDGE WAY
Mailing Address - Street 2:APT C2
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-1119
Mailing Address - Country:US
Mailing Address - Phone:240-463-0848
Mailing Address - Fax:
Practice Address - Street 1:107 GRANBERRY ST
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4547
Practice Address - Country:US
Practice Address - Phone:832-644-6496
Practice Address - Fax:832-644-6499
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9935207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine