Individual
PETER THOMAS JANICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1615 HOSPITAL PKWY, STE. 210, BEDFORD, TX 76022-5934
(817) 540-3121
(817) 355-4511
Mailing address
7508 MOUNT VERNON DR, COLLEYVILLE, TX 76034-6924
(817) 498-8944
(817) 355-4511
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H1970
TX
Other
Enumeration date
11/07/2005
Last updated
02/22/2008
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