Provider Demographics
NPI:1386731917
Name:PAZZAGLIA, PEGGY J (MD)
Entity type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:J
Last Name:PAZZAGLIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1433 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758
Mailing Address - Country:US
Mailing Address - Phone:512-491-8444
Mailing Address - Fax:512-491-0226
Practice Address - Street 1:1433 FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758
Practice Address - Country:US
Practice Address - Phone:512-491-8444
Practice Address - Fax:512-491-0226
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG89382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B25411Medicare UPIN
8D7329Medicare ID - Type Unspecified