| Russell Peckham, DO | |
|
7200 Wyoming Spgs, Suite 300, Round Rock, TX 78681-4303 | |
| (512) 910-8800 | |
| (512) 522-4483 |
| Full Name | Russell Peckham |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 25 Years |
| Location | 7200 Wyoming Spgs, Round Rock, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801816715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0102201303 (Virginia) | Secondary |
| 207N00000X | Dermatology | P5120 (Texas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Oliver Street 5.01(a) Inc | 0042464125 | 149 |
| Entity Name | Oliver Street 5.01(a) Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457695413 PECOS PAC ID: 0042464125 Enrollment ID: O20130128000189 |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Peckham, DO 7200 Wyoming Spgs, Suite 300, Round Rock, TX 78681-4303 Ph: (512) 910-8800 | Russell Peckham, DO 7200 Wyoming Spgs, Suite 300, Round Rock, TX 78681-4303 Ph: (512) 910-8800 |
Katie Benjegerdes Homan, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 302 University Blvd, Round Rock, TX 78665 Phone: 512-509-0200 | |
Ms. Morgan M Covington, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1760 Round Rock Ave, Round Rock, TX 78681 Phone: 512-583-3376 Fax: 512-666-3243 | |
Mrs. Alison Cyr Moseley, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1760 Round Rock Ave, Round Rock, TX 78681 Phone: 512-583-3376 Fax: 512-666-3243 | |
Dr. Morgan Janelle Mccarty, DO Dermatology Medicare: Accepting Medicare Assignments Practice Location: 940 Hesters Crossing Rd, Round Rock, TX 78681 Phone: 512-244-9024 Fax: 512-406-7342 | |
Dr. Ronald G Tee, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 425 University Blvd, Suite 245, Round Rock, TX 78665 Phone: 512-209-0200 | |
Sulochana S Bhandarkar, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 425 University Blvd, Round Rock, TX 78665 Phone: 512-509-0200 Fax: 512-509-0285 | |
Fareesa Shuja Sandoval, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1760 Round Rock Ave, Round Rock, TX 78681 Phone: 512-583-3376 Fax: 512-540-8175 |