Provider Demographics
NPI:1386674901
Name:PEPPER, GREGORY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:PEPPER
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 1:6921 BRISBANE CT STE 220
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7094
Mailing Address - Country:US
Mailing Address - Phone:281-980-1282
Mailing Address - Fax:281-980-2321
Practice Address - Street 1:6921 BRISBANE CT STE 220
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7094
Practice Address - Country:US
Practice Address - Phone:281-980-1282
Practice Address - Fax:281-980-2321
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8812207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160538801Medicaid
TX160538801Medicaid
TXG64614Medicare UPIN