Organization
PERITUS MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY J BRAYTON (CFO)
(972) 588-1050
Entity
Organization
Contact information
Practice address
9301 N CENTRAL EXPY # 345, DALLAS, TX 75231-0806
(972) 408-2777
(972) 692-0514
Mailing address
17111 PRESTON RD STE 100, DALLAS, TX 75248-1234
(972) 588-1050
(972) 588-1041
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/03/2013
Last updated
07/18/2014
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