Provider Demographics
NPI:1831343946
Name:PECK, STEPHEN HOUNGZIN (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:HOUNGZIN
Last Name:PECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10950 N US HWY 87,
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:TX
Mailing Address - Zip Code:76934-0038
Mailing Address - Country:US
Mailing Address - Phone:325-465-2955
Mailing Address - Fax:325-465-2874
Practice Address - Street 1:10950 N U.S. HWY 87
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:TX
Practice Address - Zip Code:76934-0038
Practice Address - Country:US
Practice Address - Phone:325-465-2955
Practice Address - Fax:325-465-2874
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6843207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine