Individual
PETER DANIEL OBESSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
120 E CHARNWOOD ST, SUITE B, TYLER, TX 75701-1708
(903) 525-1664
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
OS11800
FL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
P7011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323899001
—
TX
01
—
75-2616977-120
TRICARE
TX
01
—
752616977001
TRICARE
TX
01
—
752616977002
TRICARE
TX
01
—
752616977015
TRICARE
TX
01
—
752616977028
TRICARE
TX
01
—
P01246236
RAIL ROAD
TX
Enumeration date
05/29/2009
Last updated
10/13/2014
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