Steven James Peckham, MD

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

R1612 Issued in TX

Practice address

3300 Nacogdoches Rd
Suite 110
San Antonio, TX 78217-3373

Phone

(210) 646-0890

Fax

(210) 646-9191

NPI assigned

Mar 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1295794949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 NACOGDOCHES RD",
            "address_2": "SUITE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782173373",
            "telephone_number": "210-646-0890",
            "fax_number": "210-646-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NACOGDOCHES RD",
            "address_2": "SUITE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782173373",
            "telephone_number": "210-646-0890",
            "fax_number": "210-646-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKHAM",
        "first_name": "STEVEN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "VA",
            "license": "0101055348",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A85691",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "TX",
            "license": "R1612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Lee Peck, PTA
• Cristobal Peck II
• Jennifer Kristin Peck, OTR
• Michael Peck, M.D.
• Shannon Lea Peck, MS LPC
• Kim Peden
• Robert McNeely Peden, LPC
• Annette Johanna Pedersen, LPC
• Craig Steven Pedersen, D.O.
• Jacqueline Pedersen, RDN, LD

• Anatomic Pathology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Anatomic Pathology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.