Individual
DANIEL L PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3003 BEE CAVES RD STE 201, AUSTIN, TX 78746-5550
(512) 795-2225
(512) 795-0701
Mailing address
3003 BEE CAVES RD STE 201, AUSTIN, TX 78746-5550
(512) 795-2225
(512) 795-0701
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
J6207
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120619503
TPI
TX
01
—
140005923
MEDICARE RAILROAD
TX
01
—
4599570
AETNA
TX
01
—
89732F
BLUE CROSS BLUE SHIELD
TX
05
—
P000N72D6
—
TX
Enumeration date
12/11/2006
Last updated
08/06/2024
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