=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114070166
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JASON EDWARD PETERS, M.D., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2007
-----------------------------------------------------
Last Update Date | 02/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1023 FERGUSON DR
-----------------------------------------------------
City | HARLINGEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78550-9041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-245-1347
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1023 FERGUSON DR
-----------------------------------------------------
City | HARLINGEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78550-9041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JASON E PETERS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 956-423-9111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | M4911
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------