Katie Pekarek, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P9190 Issued in TX

Practice address

2900 E 29TH St
100
Bryan, TX 77802-2622

Phone

(979) 436-0485

NPI assigned

Jun 21, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1073809794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022622",
            "telephone_number": "979-436-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST",
            "address_2": "100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022622",
            "telephone_number": "979-436-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEKAREK",
        "first_name": "KATIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BPI0040279",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P9190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "1O0177",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Collin James Peacock, PHARMD
• Roderick Leighton Peddy, DC
• Shelli Peevey
• Charles Kevin Peirce, M.D.
• Diana Marie Peirce, M.D.
• Miranda Leigh Pelzel, APRN
• Rita Sonia Pena, L.M.T
• Jeanine M Penland, LMT
• Lourdes Percino
• Melissa Perez Figueroa

• Family Medicine Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.