Individual
PETER T WOLLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5011 BURNET RD, AUSTIN, TX 78756-2611
(512) 583-2020
(512) 744-2020
Mailing address
5011 BURNET RD, AUSTIN, TX 78756-2611
(512) 583-2020
(512) 744-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M0975
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173163001
—
TX
01
—
8M5286
BLUE CROSS
—
Enumeration date
08/10/2005
Last updated
07/01/2013
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