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General NPI Number Information
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NPI Number | 1932294089
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Entity Type | Individual
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Provider Name | PETER THOMAS VANNUCCHI DPM
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 10611 GARLAND ROAD SUITE 202
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City | DALLAS
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State | TX
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Zip | 75218
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Country | US
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Telephone | 214-328-9425
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Fax | 214-328-9426
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Provider Business Mailing Address
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Address Line | 10611 GARLAND ROAD SUITE 202
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City | DALLAS
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State | TX
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Zip | 75218
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Country | US
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Telephone | 214-328-9425
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Fax | 214-328-9426
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0464
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License Number State | TX
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