Individual
DR. PETER C KWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD1
Contact information
Practice address
1600 CENTRAL DR, SUITE 200, BEDFORD, TX 76022
(817) 399-9997
(817) 399-0694
Mailing address
1600 CENTRAL DR, SUITE 200, BEDFORD, TX 76022
(817) 399-9997
(817) 399-0694
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
J9144
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008EK
BLUECROSSBLUESHIELD
TX
01
—
0154920267
PACIFICARE
TX
05
—
113538602
—
TX
01
—
2285320
AETNA
TX
01
—
8215807004
CIGNA
TX
Enumeration date
08/31/2006
Last updated
04/29/2011
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