Provider Demographics
NPI:1235246224
Name:FOX, PETER T (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:T
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-4000
Mailing Address - Fax:210-450-4903
Practice Address - Street 1:8403 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3904
Practice Address - Country:US
Practice Address - Phone:210-567-8100
Practice Address - Fax:210-567-8103
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ0491207U00000X, 2084D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX219529901Medicaid
TXTXB119302Medicare PIN