Provider Demographics
NPI:1144350679
Name:PEGGS, MICHAEL A SR (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:PEGGS
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1713 MERLIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3129
Mailing Address - Country:US
Mailing Address - Phone:979-244-3558
Mailing Address - Fax:979-244-5352
Practice Address - Street 1:1713 MERLIN ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3129
Practice Address - Country:US
Practice Address - Phone:979-244-3558
Practice Address - Fax:979-244-5352
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM5879207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613128Medicare PIN
TXE62490Medicare UPIN