MEDICARE: FRANK ADOLPH PELTIER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	F1894	TX

General Provider Information

NPI Number	:	1154515740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK ADOLPH PELTIER M.D.

Provider Business Mailing Address
First Line	:	215 OAK DR S STE C
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5617
Country	:	US
Telephone Number	:	979-297-6458
Fax Number	:	979-297-0076

Provider Business Practice Location Address
First Line	:	215 OAK DR S STE C
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5617
Country	:	US
Telephone Number	:	979-297-6458
Fax Number	:	979-297-0076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	08/28/2007

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