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General NPI Number Information
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NPI Number | 1720157365
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Entity Type | Individual
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Provider Name | CRAIG ANDREW PETERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 2350 N. STEMMONS FREEWAY SUITE F4300
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City | DALLAS
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State | TX
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Zip | 75207
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Country | US
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Telephone | 214-456-2444
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Fax | 214-456-2497
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Provider Business Mailing Address
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Address Line | 1935 MEDICAL DISTRICT DRIVE MAIL STOP F4.04
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City | DALLAS
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State | TX
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Zip | 75235
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Country | US
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Telephone | 214-456-4677
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Fax | 214-456-8803
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101239362
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | Q5901
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License Number State | TX
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