Provider Demographics
NPI:1154533743
Name:PECKHAM, ELIZABETH LYNN ULRICH (DO)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LYNN ULRICH
Last Name:PECKHAM
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Gender:F
Credentials:DO
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Mailing Address - Street 1:16040 PARK VALLEY DR
Mailing Address - Street 2:BUILDING B, SUITE 100
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-3578
Mailing Address - Country:US
Mailing Address - Phone:512-218-1222
Mailing Address - Fax:512-218-1393
Practice Address - Street 1:16040 PARK VALLEY DR
Practice Address - Street 2:BUILDING B, SUITE 100
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-3578
Practice Address - Country:US
Practice Address - Phone:512-218-1222
Practice Address - Fax:512-218-1393
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2023-07-30
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Provider Licenses
StateLicense IDTaxonomies
TXM75132084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology