KENDALL PETERSON (NPI# 1265890057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265890057 |
| Entity Type | Individual |
| Full Name | KENDALL PETERSON |
| Credential | P.A.-C |
| Practice Address |
7777 Forest Ln Ste B107 Dallas TX 75230-6888 |
| Practice Telephone | 9725667300 |
| Practice Fax Number | 9725667313 |
| Mailing Telephone | 9725667300 |
| Mailing Fax Number | 9725667313 |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2016-02-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265453757 | Kendall R Peterson | Pharmacist | 401 County Road 42 E, Burnsville, MN 55306-5706 | 2006-07-21 |
| 1427525955 | Kendall Peterson | Physical Therapist | 17580 Interstate 45 S, Conroe, TX 77384-4972 | 2018-11-02 |
| Street Address |
7777 FOREST LN STE B107 |
| City | DALLAS |
| State | TX |
| Zip Code | 75230-6888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558752436 | Wellspring Plastic Surgery Pllc | Physician Assistant | 7777 Forest Ln Ste B107, Dallas, TX 75230-6888 | 2015-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912552415 | Kyoto Medical Services, Pllc | Orthopaedic Surgery | 12890 Hillcrest Plaza Drive, Suite K111, Dallas, TX 75230 | 2019-08-02 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1538634399 | Tochukwu Chioma Uche-ukah | Nurse Practitioner | Dr Katari, Encompass Health Rehabilitations, 7930 Northaven Rd, Dallas, TX 75230 | 2018-10-09 |
| 1790260958 | Ability Aba, Pllc | Behavioral Analyst | 5930 Royal Lane Ste E, #301, Dallas, TX 75230 | 2018-10-03 |
| 1750887956 | Brandi Nicole Freeman | Behavioral Analyst | 5639 Mcshann Rd, Dallas, TX 75230 | 2018-04-05 |
| 1326547720 | Whitney A Stewart | Psychologist | 5924 Royal Lane, Ste 258, Preston Hollow Health & Wellness, Dallas, TX 75230 | 2018-02-12 |
| 1407384373 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7859 Walnut Hill Ln Ste 110, Dallas, TX 75230 | 2017-05-23 |
| 1215488648 | The Walker Wellness Clinic | Community/Behavioral Health | 12200 Preston Rd., Dallas, TX 75230 | 2016-10-20 |
| 1578912325 | Renat Kudyakov | Nurse Practitioner | 7777 Forest Ln Ste B-446, Dallas, TX 75230 | 2016-06-11 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| Find all providers in zip 75230 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326691957 | Kourtney Marie Willett | Physician Assistant | 1411 N Beckley Ave Pav 3 Suite 363, Dallas, TX 75203-1259 | 2019-07-23 |
| 1003302944 | Amk Provider Solutions Pllc | Physician Assistant | 8197 Midtown Blvd Apt 15101, Dallas, TX 75231-4566 | 2018-07-03 |
| 1184136632 | Pa Solutions, Pllc | Physician Assistant | 1408 N Riverfront Blvd # 166, Dallas, TX 75207-3912 | 2017-10-24 |
| 1528589918 | Operator Assistants, LLC | Physician Assistant | 8440 Walnut Hill Ln Ste 250, Dallas, TX 75231-3815 | 2017-07-06 |
| 1447603683 | Exos Surgical Assist, Pllc | Physician Assistant | 7324 Gaston Ave Ste 124-90, Dallas, TX 75214-6126 | 2016-07-22 |
| 1871941419 | Premier Physician Surgical Associates, Pllc | Physician Assistant | 9540 Garland Rd # 381-416, Dallas, TX 75218-5004 | 2016-05-24 |
| 1144686452 | Clara Joplin | Physician Assistant | 10830 N. Central Expy. Suite 120, Dallas, TX 75231-1050 | 2016-01-04 |
| 1689057820 | Horizon Pa Services, Pllc | Physician Assistant | 381 Casa Linda Plz # 417, Dallas, TX 75218-3471 | 2015-07-07 |
| 1942681572 | Ridgeback Assist, Pllc | Physician Assistant | 381 Casa Linda Plz # 418, Dallas, TX 75218-3471 | 2015-06-09 |
| 1164802385 | Kris Holmes Pa Pllc | Physician Assistant | 740 Peavy Rd, Dallas, TX 75218-2149 | 2015-06-03 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.