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Individual

DR. PETER LANASA SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
801 W INTERSTATE 20, SUITE 1, ARLINGTON, TX 76017-5851
(817) 417-1132
(817) 804-8166
Mailing address
801 W INTERSTATE 20, SUITE 1, ARLINGTON, TX 76017-5851
(817) 417-1132
(817) 804-8166

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
L8788
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1650251-01
TX
05
1650251-02
TX
05
165025105
TX
01
165025106
MEDICAID OTHER
TX
05
165025106
TX
05
165025107
TX
Enumeration date
05/10/2006
Last updated
11/25/2019
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