Individual
DR. PETER UNTALAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 NORTH IH-35, SUITE 770, AUSTIN, TX 78705
(512) 482-8880
(512) 476-0467
Mailing address
3000 NORTH IH-35, SUITE 770, AUSTIN, TX 78705
(512) 482-8880
(512) 476-0467
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
K7930
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
K7930
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153535301
—
TX
Enumeration date
07/27/2006
Last updated
06/12/2012
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