Provider Demographics
NPI:1306018676
Name:WILLIAM J PECHE, M.D., P. A
Entity Type:Organization
Organization Name:WILLIAM J PECHE, M.D., P. A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:PECHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-225-2641
Mailing Address - Street 1:205 E EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4748
Mailing Address - Country:US
Mailing Address - Phone:210-225-2641
Mailing Address - Fax:210-225-7873
Practice Address - Street 1:205 E EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4748
Practice Address - Country:US
Practice Address - Phone:210-225-2641
Practice Address - Fax:210-225-7873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BE100OtherBLUE CROSS
TX033225601Medicaid
TX033225601Medicaid