Individual
CYNTHIA PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6620 MAIN ST, HOUSTON, TX 77030-2348
(713) 798-2500
(713) 798-2505
Mailing address
6620 MAIN ST, HOUSTON, TX 77030-2348
(713) 798-2500
(713) 798-2505
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
K0536
TX
208000000X
Pediatrics Physician
Primary
K0536
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124056609
—
TX
Enumeration date
10/17/2006
Last updated
03/11/2011
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