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General NPI Number Information
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NPI Number | 1295926574
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Entity Type | Individual
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Provider Name | PETER SCOTT NELSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 3030 NORTH ST SUITE 430 (BEAUMONT DERMATOLOGY & FAMILY PRACTICE)
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City | BEAUMONT
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State | TX
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Zip | 77702-1433
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Country | US
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Telephone | 409-899-2500
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Fax | 409-898-7579
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Provider Business Mailing Address
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Address Line | 3030 NORTH ST SUITE 430
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City | BEAUMONT
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State | TX
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Zip | 77702-1433
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Country | US
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Telephone | 409-899-2500
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Fax | 409-898-7579
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD.201378
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | M9537
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License Number State | TX
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