Individual
PETER THEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
252 MATLOCK RD STE 234, MANSFIELD, TX 76063-6565
(214) 948-2076
Mailing address
252 MATLOCK RD STE 234, MANSFIELD, TX 76063-6565
(214) 948-2076
(214) 948-9990
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
036152108
IL
207T00000X
Neurological Surgery Physician
Primary
V9427
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2017
Last updated
07/21/2025
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