Individual
DALLAS ELWOOD PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 W CENTRAL TEXAS EXPY STE 117, HARKER HEIGHTS, TX 76548-1888
(254) 457-4432
(254) 618-4941
Mailing address
300 W CENTRAL TEXAS EXPY STE 117, HARKER HEIGHTS, TX 76548-1888
(254) 457-4432
(254) 618-4941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23268
AZ
207Q00000X
Family Medicine Physician
Primary
R4764
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315441
—
AZ
Enumeration date
02/01/2006
Last updated
06/23/2025
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