Organization
PETERSON MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MEDOVICH (CFO)
(830) 258-7632
Entity
Organization
Contact information
Practice address
575 HILL COUNTRY DR, STE 202, KERRVILLE, TX 78028-6024
(830) 258-6237
(830) 315-1366
Mailing address
PO BOX 26499, BELFAST, ME 04915-2015
(830) 258-7343
(830) 258-7678
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
550119
TX
207R00000X
Internal Medicine Physician
550119
TX
207V00000X
Obstetrics & Gynecology Physician
Primary
550119
TX
Other
Enumeration date
05/03/2010
Last updated
03/11/2023
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