Individual
CARLOTTA PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 W MAIN ST STE 200, LEWISVILLE, TX 75057-3639
(877) 314-8990
Mailing address
6750 N MACARTHUR BLVD STE 270, IRVING, TX 75039-2469
(877) 314-8990
(844) 364-3321
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00598
TX
363AM0700X
Medical Physician Assistant
PA00598
TX
Other
Enumeration date
01/22/2010
Last updated
01/06/2022
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