Individual
CHEA Z PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.T (R) (M)/CPT
Contact information
Practice address
7533 KRYPTON DR, CORPUS CHRISTI, TX 78414-3140
(252) 308-3215
Mailing address
7533 KRYPTON DR, CORPUS CHRISTI, TX 78414-3140
(252) 308-3215
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
GMR02010074
TX
246RP1900X
Phlebotomy Technician
NPCN-16623-1949
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GMR02010074
R.T (R)
TX
Enumeration date
10/07/2022
Last updated
10/07/2022
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