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Organization
SOUTHLAKE EMERGICARE PLLC
Active
Organization
SOUTHLAKE EMERGICARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL E PECKENPAUGH MD (DIRECTOR)
(877) 485-4474
Entity
Organization
Contact information
Practice address
1545 E SOUTHLAKE BLVD, ER DEPT, SOUTHLAKE, TX 76092-6422
(817) 748-8700
Mailing address
PO BOX 720508, NORMAN, OK 73070-4373
(877) 485-4474
(405) 341-9217
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
07/16/2014
Last updated
11/07/2019
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