Organization
CHARLES K. PEIRCE, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES KEVIN PEIRCE M.D. (PRESIDENT)
(979) 731-8660
Entity
Organization
Contact information
Practice address
3201 UNIVERSITY DR E, SUITE 440, BRYAN, TX 77802-3475
(979) 731-8660
Mailing address
3201 UNIVERSITY DR E, SUITE 440, BRYAN, TX 77802-3475
(979) 731-8660
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088PV
BLUE CROSS PROVIDER NUMBER
TX
01
—
00U13R
BLUE CROSS PROVIDER NUMBE
TX
05
—
126609005
—
TX
05
—
200220601
—
TX
Enumeration date
10/10/2006
Last updated
12/15/2011
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