PHYLLIS ROSE PETERSON


Address: Ttuhsc Dept of Psychiatry, 3601 4th St., Ms 8103, Lubbock, TX 79430-8103
Phone: 8067432800

PHYLLIS ROSE PETERSON (NPI# 1346246634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346246634
Entity Type Individual
Full Name PHYLLIS ROSE PETERSON
Credential PA
Practice Address Ttuhsc Dept of Psychiatry
3601 4th St., Ms 8103
Lubbock
TX 79430-8103
Mailing Address Ttuhsc Dept of Psychiatry
3601 4th St.
Lubbock
TX 79430-8103
Practice Telephone 8067432800
Practice Fax Number 8067432784
Mailing Telephone 8067816069
Enumeration Date 2005-06-22
Last Update Date 2015-05-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA01015 TX Physician Assistants & Advanced Practice Nursing Providers

Other Providers PHYLLIS PETERSON

NPI Name Taxonomy Address Enumeration
1366703019 Phyllis G Peterson Nurse Practitioner 103 Dr. Bowen St., Belle Chasse, LA 70037 2012-05-30
1629157508 Phyllis Lee Peterson Physical Therapist 3112 N Ocoee St, Cleveland, TN 37312 2006-11-03

Office Location

Street Address TTUHSC DEPT OF PSYCHIATRY
3601 4TH ST., MS 8103
City LUBBOCK
State TX
Zip Code 79430-8103

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1730702473 Emily Bouffard Student in an Organized Health Care Education/Training Program 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 2020-05-27
1891350310 Erin Leigh Burton Student in an Organized Health Care Education/Training Program 3601 Fourth Street, Department of Surgery Ms 8312, Lubbock, TX 79430 2019-05-09
1851861439 Zachery Brian Sneed Counselor 3b310, 3601 4th St Stop 6225, Lubbock, TX 79430 2018-11-27
1831683481 Swagat Parajulee Student in an Organized Health Care Education/Training Program 3601 4th St., Stop 9410, Office 4b076, Lubbock, TX 79430 2018-06-18
1649711904 William David Boothe Jr. Dermatology 3601 4th St Stop 6211, Lubbock, TX 79430 2017-03-19
1982144945 Kazutaka Araki Specialist/Technologist 3601, 4th St, Lubbock, TX 79430 2017-02-24
1659725125 Thomas Gregory Wyatt Student in an Organized Health Care Education/Training Program 3601 4th St Rm 3a122b, Lubbock, TX 79430 2016-04-20
1619391760 Chinyere Mbagwu General Practice 3601 4th St # Ms 8143, Lubbock, TX 79430 2014-02-10
1982044111 Eileen Mary Sprys Family Medicine 3601 4th St., Stop 8143, Lubbock, TX 79430 2013-07-02
1205196243 Hilmi Alam Family Medicine Department of Family & Community Medicine, 3601 4th Street, Stop 8143, Lubbock, TX 79430 2012-05-24
Find all providers in zip 79430

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316294408 Ronald Caporale Physician Assistant 1701 50th Street, Lubbock, TX 79412 2012-08-08
1699002675 Jamie Fletcher Physician Assistant 5415 114th St, Lubbock, TX 79424 2009-11-11
1710160700 Jessica Ferguson Physician Assistant 3606 21st St Ste 200, Lubbock, TX 79410-1225 2007-12-12
1104958560 Janice Hallford Lampe Physician Assistant 6048 Marsha Sharp Fwy, Lubbock, TX 79407-3726 2007-03-12
1699819953 Holly Jen Tyson Physician Assistant 3811 24th St, Lubbock, TX 79410-1813 2007-02-19
1154496974 Kathleen Jo Marcum Physician Assistant 3801 21st St, Suite 200, Lubbock, TX 79410-1006 2006-11-21
1336252220 Gustavo Alonso Bendeck Physician Assistant 4010 22nd St, Lubbock, TX 79410-1116 2006-08-16
1316903875 Kristina Lee Physician Assistant 3904 101st St, Lubbock, TX 79423-5725 2006-04-25
1467416636 David Anthony King Physician Assistant 3514 21st Street, Lubbock, TX 79410 2006-04-14
1629072277 Joni Cline Physician Assistant 4404 19th St Ste C, Lubbock, TX 79407-2424 2005-06-10
Find all providers in LUBBOCK

Competitor

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City LUBBOCK
Zip Code 79430

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Dataset Information

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.

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