Provider Demographics
NPI:1851961031
Name:BAYDU, PETER (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:BAYDU
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:BAYDU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AGACNP -BC
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:6204 BALCONES DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4214
Practice Address - Country:US
Practice Address - Phone:512-421-4250
Practice Address - Fax:512-822-7640
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020973363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty