Individual
DR. ERIC J PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 E TORONTO AVE, MCALLEN, TX 78503-1209
(956) 687-6155
(956) 618-0451
Mailing address
1550 S STAPLES ST, STE 150, CORPUS CHRISTI, TX 78404-3123
(361) 800-8155
(361) 882-2590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
43275
TX
207Q00000X
Family Medicine Physician
7333423-1205
UT
207Q00000X
Family Medicine Physician
MD 60036832
WA
207Q00000X
Family Medicine Physician
Primary
N8336
TX
390200000X
Student in an Organized Health Care Education/Training Program
ML 20009169
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20009169
MEDICAL LICENSE
WA
01
—
7333423-1205
MEDICAL LICENSE
UT
01
—
MD 60036832
WASHINGTON
WA
01
—
N8336
MEDICAL LICENSE
TX
Enumeration date
05/06/2008
Last updated
07/12/2016
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