Provider Demographics
NPI:1124026752
Name:PETERS, KURT R (MD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:R
Last Name:PETERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9223 WEST BROADWAY STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9759
Mailing Address - Country:US
Mailing Address - Phone:281-412-7111
Mailing Address - Fax:832-456-1703
Practice Address - Street 1:9223 WEST BROADWAY STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9759
Practice Address - Country:US
Practice Address - Phone:281-412-7111
Practice Address - Fax:832-456-1703
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2015-08-31
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Provider Licenses
StateLicense IDTaxonomies
TXH8797207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E52449Medicare UPIN
TX876210Medicare PIN