Provider Demographics
NPI:1245233055
Name:AMARAL, PETER G (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:G
Last Name:AMARAL
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 1:635 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-5412
Mailing Address - Country:US
Mailing Address - Phone:979-830-1444
Mailing Address - Fax:979-830-1866
Practice Address - Street 1:635 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5412
Practice Address - Country:US
Practice Address - Phone:979-830-1444
Practice Address - Fax:979-830-1866
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4173207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035787302Medicaid
TX035787301Medicaid
TX00RX35Medicare PIN
TX035787301Medicaid
TX389358YT4LMedicare PIN