Individual
PEGGY P. JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
246240
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041564802
—
TX
05
—
041564803
—
TX
05
—
041564804
—
TX
05
—
041564805
—
TX
05
—
041564806
—
TX
05
—
041564807
—
TX
05
—
041564808
—
TX
05
—
041564809
—
TX
05
—
041564810
—
TX
05
—
041564811
—
TX
05
—
041564812
—
TX
05
—
041564813
—
TX
01
—
8N4798
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/28/2005
Last updated
03/27/2009
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