Individual
DR. PETER JONATHAN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
6431 FANNIN ST, HOUSTON, TX 77030
(713) 500-5140
Mailing address
3300 CUMMINS ST, 2356, HOUSTON, TX 77027-5893
(713) 557-5992
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
P9171
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10041003
TX
Other
Enumeration date
08/29/2012
Last updated
04/06/2014
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