Peggy Wongsa, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

K0204 Issued in TX

Practice address

21212 Northwest Fwy Ste 215
Cypress, TX 77429-5885

Phone

(281) 897-1122

Fax

(281) 897-0777

NPI assigned

Mar 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Pakkinee Sriwatanawongsa Former name

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1699743674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21212 NORTHWEST FWY STE 215",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774295885",
            "telephone_number": "281-897-1122",
            "fax_number": "281-897-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21212 NORTHWEST FWY STE 215",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774295885",
            "telephone_number": "281-897-1122",
            "fax_number": "281-897-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONGSA",
        "first_name": "PEGGY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K0204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092170203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAKKINEE",
            "last_name": "SRIWATANAWONGSA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatrics Physician in Cypress, TX
• Providers in Cypress, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.