Individual
DR. ROBERT PEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
900 JEROME ST, SUITE 140, FORT WORTH, TX 76104-3945
(817) 522-1833
Mailing address
900 JEROME ST, SUITE 140, FORT WORTH, TX 76104-3945
(817) 522-1833
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16382
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85D054
BCBS OF TX
TX
Enumeration date
04/12/2007
Last updated
12/22/2014
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