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Individual
DON N PESKA
Active
Individual
DON N PESKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
G2454
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
G2454
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115932903
—
TX
01
—
120002038
RAILROAD MEDICARE PIN
TX
01
—
846873
BCBS
TX
Enumeration date
06/16/2006
Last updated
09/20/2011
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