# PETERSON MEDICAL ASSOCIATES

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

## Provider details

- **NPI number:** 1770800575
- **Authorized official:** LISA MEDOVICH (CFO)
- **Authorized official phone:** (830) 258-7632

## Contact information

- **Practice address:** 575 HILL COUNTRY DR, STE 202, KERRVILLE, TX 78028-6024
- **Practice address phone:** (830) 258-6237
- **Practice address fax:** (830) 315-1366
- **Mailing address:** PO BOX 26499, BELFAST, ME 04915-2015
- **Mailing address phone:** (830) 258-7343
- **Mailing address fax:** (830) 258-7678

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 550119 | TX | — |
| 207R00000X | Internal Medicine Physician | 550119 | TX | — |
| 207V00000X | Obstetrics & Gynecology Physician | 550119 | TX | Yes |

## Other

- **Enumeration date:** 05/03/2010
- **Last updated:** 03/11/2023