Healthcare Provider Details

I. General information

NPI: 1740507649
Provider Name (Legal Business Name): PETER I HESSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2010
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12221 MERIT DR STE 1500
DALLAS TX
75251-2235
US

IV. Provider business mailing address

12221 MERIT DR STE 1500
DALLAS TX
75251-2235
US

V. Phone/Fax

Practice location:
  • Phone: 214-217-1911
  • Fax:
Mailing address:
  • Phone: 214-217-1911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberBP10037123
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP1325
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: