Individual
DANIEL PETR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
709 W LEUDA ST, FORT WORTH, TX 76104-3115
(817) 926-2511
(817) 924-0167
Mailing address
709 W LEUDA ST, FORT WORTH, TX 76104-3115
(817) 926-2511
(817) 924-0167
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04844
TX
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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