EDWARD J PETRUS


Address: 3413 Spanish Oak Dr, Austin, TX 78731
Phone: 5124546500

EDWARD J PETRUS (NPI# 1821172289) 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) 1821172289
Entity Type Individual
Full Name EDWARD J PETRUS
Credential MD
Practice Address 3413 Spanish Oak Dr
Austin
TX 78731
Practice Telephone 5124546500
Practice Fax Number 5124530066
Mailing Telephone 5124546500
Mailing Fax Number 5124530066
Enumeration Date 2006-10-24
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice D6520 TX Allopathic & Osteopathic Physicians

Office Location

Street Address 3413 SPANISH OAK DR
City AUSTIN
State TX
Zip Code 78731

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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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1225685712 Integrative Medical Group of Texas General Practice 6905 West Gate Blvd. Ste A, Austin, TX 78745 2019-08-20
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1073066239 The University of Texas At Austin General Practice 1601 Trinity Street, Austin, TX 78712 2016-07-25
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1649694035 John Maxwell General Practice 12817 Hacienda Rdg, Austin, TX 78738-7652 2014-02-06
1982031852 Total Md Physicians Group, Pllc General Practice 12717 Shops Pkwy, Suite 500, Austin, TX 78738-6621 2013-10-08
1932440245 Travis County Employee Wellness & Health General Practice 1010 Lavaca St # 221, Austin, TX 78701-2331 2013-03-12
1447590765 David L King General Practice 10609 Pickfair Dr, Austin, TX 78750-4010 2013-02-23
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Competitor

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City AUSTIN
Zip Code 78731

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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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