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General NPI Number Information
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NPI Number | 1720209406
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Entity Type | Organization
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Legal Business Name | F CHARLES PETR MD PA
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 2391 NE LOOP 410 SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5600
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Country | US
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Telephone | 210-656-3376
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Fax | 210-656-4864
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Provider Business Mailing Address
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Address Line | 2391 NE LOOP 410 SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5600
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Country | US
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Telephone | 210-656-3376
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Fax | 210-656-4864
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. SANDRA DAWN SMITH
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Credential |
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Telephone | 210-656-3376
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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 | H2684
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License Number State | TX
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