# PETER G. MCDOUGALL M.D.

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

## Provider details

- **NPI number:** 1427242932
- **Authorized official:** DR. PETER GORDON MCDOUGALL M.D. (OWNER)
- **Authorized official phone:** (817) 307-5101

## Contact information

- **Practice address:** 6609 CROOKED STICK DR, FORT WORTH, TX 76132
- **Practice address phone:** (817) 307-5101
- **Mailing address:** 6609 CROOKED STICK DR, FORT WORTH, TX 76132-4526
- **Mailing address phone:** (817) 307-5101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | E8068 | TX | Yes |

## Other

- **Enumeration date:** 08/29/2007
- **Last updated:** 02/11/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00766R | MEDICARE GROUP NUMBER | TX |