Individual
JEAN PETERSHACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 257-1400
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
J2971
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044835901
CIDC
TX
05
—
044835902
—
TX
Enumeration date
08/08/2006
Last updated
06/17/2008
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