Individual
DR. PETER JOHN WILTSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3608 PRESTON RD, STE 150, PLANO, TX 75093-8655
(972) 566-4040
(972) 769-0884
Mailing address
3608 PRESTON RD, SUITE 150, PLANO, TX 75093-8655
(972) 566-4040
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G8514
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032033502
—
TX
01
—
8R5383
BLUE CROSS
TX
Enumeration date
06/16/2005
Last updated
05/31/2013
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