Provider Demographics
NPI:1679039077
Name:PEACE, HELEN VARA
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:VARA
Last Name:PEACE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 SYCAMORE AVE APT 728
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-6250
Mailing Address - Country:US
Mailing Address - Phone:214-766-1690
Mailing Address - Fax:
Practice Address - Street 1:7777 GLEN AMERICA DR APT 131
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-1845
Practice Address - Country:US
Practice Address - Phone:214-766-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer