Individual
DR. CHARLES KEVIN PEIRCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3201 UNIVERSITY DR E, STE 370, BRYAN, TX 77802-3475
(979) 731-8660
Mailing address
3201 UNIVERSITY DR E, STE 440, BRYAN, TX 77802-3486
(979) 731-8660
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
J5624
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U13R
BLUE CROSS PROVIDER NUMBE
TX
05
—
126609005
—
TX
05
—
126609006
—
TX
01
—
8AG630
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/10/2006
Last updated
05/14/2020
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