DON N PESKA (NPI# 1518901842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518901842 |
| Entity Type | Individual |
| Full Name | DON N PESKA |
| Credential | DO |
| Practice Address |
855 Montgomery St Fort Worth TX 76107-2553 |
| Mailing Address |
Po Box 99335 Fort Worth TX 76199-0335 |
| Practice Telephone | 8177355450 |
| Practice Fax Number | 8177355454 |
| Mailing Telephone | 8177355450 |
| Mailing Fax Number | 8177355454 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2011-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
G2454 | TX | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | G2454 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 846873 | 01 |
| TX | RAILROAD MEDICARE PIN | 120002038 | 01 |
| TX | 115932903 | 05 |
| Street Address |
855 MONTGOMERY ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194455 | Patricia Lowrimore | Psychiatry & Neurology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2005-06-20 |
| 1194353417 | Jason L Thompson | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-03-31 |
| 1639701808 | Tyrane Roberts-lagrone | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-02-06 |
| 1144860917 | Melissa Edwards Petersen | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-01-09 |
| 1629553813 | Lisa Jane Killam-worrall | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-10-03 |
| 1598250607 | Sima Taj Mozdbar | Optometrist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-06-30 |
| 1588153993 | Kristen Reuter | Social Worker | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-05-02 |
| 1114431624 | Emily J. Clark | Counselor | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-11-20 |
| 1275073215 | Elizabeth Svyatoslavna Balyakina | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-23 |
| 1588103659 | Frederick Olen Barnum Iv | Family Medicine | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558702373 | Texas Health Care, P.l.l.c. | Surgery | 1307 8th Ave Ste 302, Fort Worth, TX 76104-4140 | 2013-07-09 |
| 1487962916 | Texas Health Care, P.l.l.c. | Surgery | 1250 8th Ave., Suite 240, Fort Worth, TX 76104-4124 | 2010-09-17 |
| 1326061961 | Charles Adger West Jr. | Surgery | 1325 Pennsylvania Ave Ste 680, Fort Worth, TX 76104-2133 | 2006-07-25 |
| 1538186135 | David L Stroman | Surgery | 1250 8th Ave., Suite 240, Fort Worth, TX 76104-4124 | 2006-07-17 |
| 1740825264 | Johnna Jones Do Facos Pa | Surgery | 800 8th Ave Ste 116, Fort Worth, TX 76104-2606 | 2019-11-07 |
| 1376947135 | Vikram Palkar | Surgery | 1500 S Main St, Fort Worth, TX 76104-4917 | 2014-10-22 |
| 1851668925 | Fort Worth Vascular and Surgical Associates, Pa | Surgery | 909 9th Ave, Suite 201, Fort Worth, TX 76104-3903 | 2011-11-17 |
| 1013173764 | Vascular and Vein Center Pa | Surgery | 1325 Pennsylvania Ave, Suite 440, Fort Worth, TX 76104-2128 | 2008-08-01 |
| 1134308091 | North Texas Vein Partners, LLC | Surgery | 2737 S Hulen St, Fort Worth, TX 76109-9535 | 2007-10-29 |
| 1720274533 | Saadi Mohy Aldeen Halbouni | Surgery | 800 8th Ave Ste 306, Fort Worth, TX 76104-2602 | 2007-09-15 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
Please comment or provide details below to improve the information on DON N PESKA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.