Provider Demographics
NPI:1336175140
Name:ROJAS, PETER PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:PAUL
Last Name:ROJAS
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 1:601 E SAN ANTONIO ST
Mailing Address - Street 2:STE 501
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-6004
Mailing Address - Country:US
Mailing Address - Phone:361-575-6396
Mailing Address - Fax:361-575-2728
Practice Address - Street 1:601 E SAN ANTONIO ST
Practice Address - Street 2:STE 501
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6004
Practice Address - Country:US
Practice Address - Phone:361-575-6396
Practice Address - Fax:361-575-2728
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7276208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020011873OtherRAILROAD MEDICARE
TX4341361OtherAETNA
TX816534OtherBLUECROSS BLUESHIELD
TX101957202Medicaid
TX816534Medicare ID - Type Unspecified
TX020011873OtherRAILROAD MEDICARE
TX101957202Medicaid