Provider Demographics
NPI:1548525652
Name:PELTON, DANNY WAYNE (ATP)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:WAYNE
Last Name:PELTON
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:HICO
Mailing Address - State:TX
Mailing Address - Zip Code:76457-0579
Mailing Address - Country:US
Mailing Address - Phone:254-644-0422
Mailing Address - Fax:254-796-2648
Practice Address - Street 1:36532 FM 2481
Practice Address - Street 2:
Practice Address - City:HICO
Practice Address - State:TX
Practice Address - Zip Code:76457-3313
Practice Address - Country:US
Practice Address - Phone:254-644-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other