Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | M1436 | TX |
Y | 207VE0102X | Reproductive Endocrinologist | M1436 | TX |
NPI | 1053337816 |
---|---|
Provider Name | Carol L Peters |
First Address | Austin, TX 78717-3951 |
Second Address | Austin, TX 78717-3951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 29/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182502802 | (05) | TX |
E82793 | (02) |