Individual
PETER A. BROKISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4851 MERLOT AVE UNIT 550, GRAPEVINE, TX 76051-7380
(940) 488-4290
(940) 536-0539
Mailing address
5150 LEMMON AVE STE 108, DALLAS, TX 75209-6428
(214) 891-5579
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD60915016
WA
207P00000X
Emergency Medicine Physician
Primary
P1852
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293617101
—
TX
01
—
P1852
TX LICENSE
TX
Enumeration date
07/05/2007
Last updated
08/01/2024
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