Provider Demographics
NPI:1073560744
Name:HOLMES, PETER F (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:F
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 HUEBNER RD
Mailing Address - Street 2:STE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1558
Mailing Address - Country:US
Mailing Address - Phone:210-696-9000
Mailing Address - Fax:210-696-9012
Practice Address - Street 1:9150 HUEBNER RD
Practice Address - Street 2:STE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1558
Practice Address - Country:US
Practice Address - Phone:210-696-9000
Practice Address - Fax:210-696-9012
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF9578207X00000X, 207XS0114X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4056366OtherAETNA ID NUMBER
4056366OtherAETNA ID NUMBER
8244N0Medicare ID - Type Unspecified