Individual
CHELSEA IRENE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
506 GRAHAM DR STE 150, TOMBALL, TX 77375-3346
(281) 351-5174
(281) 351-5172
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10340
TX
363AS0400X
Surgical Physician Assistant
PA10340
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365108502
—
TX
05
—
365108503
—
TX
Enumeration date
04/12/2016
Last updated
05/10/2023
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