Provider Demographics
NPI:1477747467
Name:PETER RAPPA MD PA
Entity Type:Organization
Organization Name:PETER RAPPA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:RAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-740-0687
Mailing Address - Street 1:13410 PRESTON RD
Mailing Address - Street 2:1-352
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5299
Mailing Address - Country:US
Mailing Address - Phone:972-386-5004
Mailing Address - Fax:
Practice Address - Street 1:13410 PRESTON RD
Practice Address - Street 2:1-352
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5299
Practice Address - Country:US
Practice Address - Phone:972-386-5004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-01
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8345208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty