Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | H2239 | TX |
NPI | 1336187731 |
---|---|
Provider Name | Dr. Peter Beitsch |
First Address | Dallas, TX 75230-6834 |
Second Address | Dallas, TX 75230-2505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 12/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
138478601 | (05) | TX |
D86995 | (02) |