Provider Demographics
NPI:1104807544
Name:PESKIND, STEVEN PHILLIP (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:PHILLIP
Last Name:PESKIND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5957 DALLAS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7822
Mailing Address - Country:US
Mailing Address - Phone:972-596-2552
Mailing Address - Fax:972-964-7209
Practice Address - Street 1:5957 DALLAS PKWY
Practice Address - Street 2:SUITE100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7822
Practice Address - Country:US
Practice Address - Phone:972-596-2552
Practice Address - Fax:972-964-7209
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7089207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00762NMedicare ID - Type Unspecified
TXF74228Medicare UPIN