Provider Demographics
NPI:1841559747
Name:PEAK MIDWIFERY AND BIRTHING CENTER
Entity Type:Organization
Organization Name:PEAK MIDWIFERY AND BIRTHING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:PRICE-WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:512-744-3037
Mailing Address - Street 1:2203 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-2430
Mailing Address - Country:US
Mailing Address - Phone:409-768-0068
Mailing Address - Fax:337-376-0176
Practice Address - Street 1:2203 N 16TH ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-2430
Practice Address - Country:US
Practice Address - Phone:409-768-0068
Practice Address - Fax:337-376-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150021261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing