Provider Demographics
NPI:1346498219
Name:PETER A TARBOX MD PA
Entity Type:Organization
Organization Name:PETER A TARBOX MD PA
Other - Org Name:NEUROLOGY CONSULTANTS OF SA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:TARBOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-573-8290
Mailing Address - Street 1:5441 BABCOCK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3993
Mailing Address - Country:US
Mailing Address - Phone:210-641-1394
Mailing Address - Fax:210-561-2846
Practice Address - Street 1:5441 BABCOCK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3993
Practice Address - Country:US
Practice Address - Phone:210-641-1394
Practice Address - Fax:210-561-2846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0313777-01Medicaid
TX89232ZOtherBC/BS OF TEXAS
TXK6358OtherLICENSE
TX00Z695Medicare PIN