Individual
ERIC WAYNE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11555 UNIVERSITY BLVD, SUGAR LAND, TX 77478-3889
(713) 442-9100
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
J2900
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045306004
—
TX
05
—
045306006
—
TX
Enumeration date
10/05/2006
Last updated
01/27/2017
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