Individual
PETER VINCENT SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 W CROSS ST, MADISONVILLE, TX 77864-2432
(936) 348-2631
Mailing address
6200 HICKORY HOLLOW LN, CONROE, TX 77304-1484
(936) 756-0948
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
K1689
TX
Other
Enumeration date
05/18/2006
Last updated
03/26/2008
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