Provider Demographics
NPI:1508802026
Name:PEA IN THE POD OB/GYN ASSOC., P.A.
Entity Type:Organization
Organization Name:PEA IN THE POD OB/GYN ASSOC., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:GEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-226-2464
Mailing Address - Street 1:343 W HOUSTON ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2107
Mailing Address - Country:US
Mailing Address - Phone:210-226-2464
Mailing Address - Fax:210-222-1129
Practice Address - Street 1:343 W HOUSTON ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2107
Practice Address - Country:US
Practice Address - Phone:210-226-2464
Practice Address - Fax:210-222-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1822207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142440001Medicaid
TX00512RMedicare ID - Type UnspecifiedMEDICARE GROUP #