Provider Demographics
NPI:1619183928
Name:PROCTOR, PETER H (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:H
Last Name:PROCTOR
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 1:4518 OAKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5531
Mailing Address - Country:US
Mailing Address - Phone:713-960-1616
Mailing Address - Fax:713-960-9307
Practice Address - Street 1:5555 WEST LOOP SOUTH
Practice Address - Street 2:SUITE 225
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77027
Practice Address - Country:US
Practice Address - Phone:713-960-1616
Practice Address - Fax:713-960-9307
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3056207N00000X, 2083T0002X, 208U00000X
TXG3059207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207N00000XAllopathic & Osteopathic PhysiciansDermatology
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical Toxicology
Not Answered208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology