Provider Demographics
NPI:1629087127
Name:RAPPA, PETER JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOHN
Last Name:RAPPA
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 1:14902 PRESTON RD
Mailing Address - Street 2:SUITE 404-804
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-9191
Mailing Address - Country:US
Mailing Address - Phone:972-428-1694
Mailing Address - Fax:972-428-1619
Practice Address - Street 1:2301 MARSH LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8497
Practice Address - Country:US
Practice Address - Phone:942-428-1694
Practice Address - Fax:972-428-1619
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8345208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128137004Medicaid
TX250013233OtherRR MEDICARE
TX128137002Medicaid
TX128137002Medicaid
TX128137004Medicaid
TX250013233OtherRR MEDICARE