Individual
MR. PETER FAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4649 MOUNTAIN OAK ST, FORT WORTH, TX 76244-4397
(209) 287-4673
Mailing address
4649 MOUNTAIN OAK ST, FORT WORTH, TX 76244-4397
(209) 287-4673
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1114862
TX
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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