# PERITUS MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356772206
- **Authorized official:** MR. LARRY J BRAYTON (CFO)
- **Authorized official phone:** (972) 588-1050

## Contact information

- **Practice address:** 9301 N CENTRAL EXPY \# 345, DALLAS, TX 75231-0806
- **Practice address phone:** (972) 408-2777
- **Practice address fax:** (972) 692-0514
- **Mailing address:** 17111 PRESTON RD STE 100, DALLAS, TX 75248-1234
- **Mailing address phone:** (972) 588-1050
- **Mailing address fax:** (972) 588-1041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/03/2013
- **Last updated:** 07/18/2014