Peters, Walter Russell
Peters, Walter Russell is an individual health care provider with primary practice located at 3409 Worth St Worth Tower, Suite 640, Dallas TX 75246-2029. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Peters, Walter Russell can be contacted via phone (469) 800-7180.Contact Information
Primary practice address
3409 Worth St Worth Tower, Suite 640
Dallas TX 75246-2029
Phone: (469) 800-7180
Fax: (469) 800-7190
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | R6G45 | Missouri |
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | R6G45 | Missouri |
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | Q6358 | Texas |
Profile Details
| NPI number | 1316941123 |
|---|---|
| LBN Legal business name | Peters, Walter Russell |
| Credentials | M.D., M.B.A |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Apr 7th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316941123 | NPPES |
| Missouri | Other | 1284609 | UNITED HEALTHCARE |
| Missouri | Other | 123497 | UNITED HEALTHCARE |
| Missouri | Other | 28058 | UNITED HEALTHCARE |
| Missouri | Other | 5125 | UNITED HEALTHCARE |
| Missouri | Other | 8FM794 | UNITED HEALTHCARE |
| Missouri | Other | 25055 | UNITED HEALTHCARE |
| Missouri | MEDICAID | 3548646-01 | UNITED HEALTHCARE |
| Missouri | Other | 4343317 | UNITED HEALTHCARE |
| Missouri | Other | 4343317 | UNITED HEALTHCARE |
| Missouri | Other | 431428562 | UNITED HEALTHCARE |
| Missouri | Other | 1316941123 | UNITED HEALTHCARE |
| Missouri | MEDICAID | 202523015 | UNITED HEALTHCARE |
| Missouri | Other | A10787 | UNITED HEALTHCARE |
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