Provider Demographics
NPI:1902096472
Name:PECK, RICHARD AUSTIN (L AC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:AUSTIN
Last Name:PECK
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5924 W PARKER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6432
Mailing Address - Country:US
Mailing Address - Phone:972-473-9070
Mailing Address - Fax:972-473-9072
Practice Address - Street 1:5924 W PARKER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6432
Practice Address - Country:US
Practice Address - Phone:972-473-9070
Practice Address - Fax:972-473-9072
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist