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General NPI Number Information
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NPI Number | 1194043513
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Entity Type | Individual
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Provider Name | BETH PETERSON MD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 2001 N JEFFERSON AVE STE 203
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City | MOUNT PLEASANT
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State | TX
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Zip | 75455-2310
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Country | US
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Telephone | 903-434-8880
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Fax | 903-434-8881
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Provider Business Mailing Address
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Address Line | 2001 N JEFFERSON AVE
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City | MOUNT PLEASANT
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State | TX
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Zip | 75455-2338
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Country | US
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Telephone | 903-577-6000
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Fax | 903-577-6245
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | Q2862
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License Number State | TX
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