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Individual

MR. DARRYL W. PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2803 EARL RUDDER FWY S STE 202, COLLEGE STATION, TX 77845-6099
(979) 731-8888
(979) 731-8935
Mailing address
2800 S TEXAS AVE STE 202, BRYAN, TX 77802-5361
(979) 774-2061
(979) 776-5914

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
12182R
LA
207X00000X
Orthopaedic Surgery Physician
K3391
TX
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
K3391
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1543365
LA
05
370416501
TX
Enumeration date
05/25/2006
Last updated
03/19/2025
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