NPIMap

Individual provider Active NPI

Dallas Elwood Peterson, M.D.

  • Family Medicine Physician
  • Harker Heights, TX
National Provider Identifier
1265403638
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R4764 Issued in TX
Practice address
300 W Central Texas Expy Ste 117
Harker Heights, TX 76548-1888
Phone
(254) 457-4432
Fax
(254) 618-4941
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R4764 TX Primary
Family Medicine Physician 207Q00000X 23268 AZ

Addresses

Primary practice location

300 W Central Texas Expy Ste 117
Harker Heights, TX 76548-1888

Mailing address

300 W Central Texas Expy Ste 117
Harker Heights, TX 76548-1888
Phone (254) 457-4432

Other identifiers 1

IdentifierTypeStateIssuer
315441MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171101003300 TX Practitioner - Family Practice 2769676626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LHP Texas MD Services, IncGroup PAC ID 8527222108, 36 clinicians

Practice addresses (Care Compare)

300 W Central Texas Expy
Suite 117
Harker Heights, TX 76548-1888
Phone (254) 547-3743

Hospital & facility affiliations

  • Hana Care Texas Home health agency, Austin, TX, CCN 453107
  • Elara Caring Home health agency, Round Rock, TX, CCN 457661
  • Enhabit Home Health Home health agency, Temple, TX, CCN 673127
  • Seton Medical Center Harker Heights Hospital, Harker Heights, TX, CCN 670080
  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054
  • Adventhealth Central Texas Hospital, Killeen, TX, CCN 450152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23268AZMDFamily Medicine Physician
R4764TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LHP Texas MD Services, Inc Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Snowflake Medical Center, PC Family Medicine Current Accepting new patients

Locations

590 S Main St
Snowflake, AZ 85937
Phone (520) 536-7519

300 W Central Texas Expy
Ste 117
Harker Heights, TX 76548
Phone (254) 340-0042

800 W Central Texas Expy
Harker Heights, TX 76548
Phone (254) 618-4933

Interoperability endpoints

  • Direct secure messaging: dpeterson838183@ahs.direct-ci.com
  • Direct secure messaging: dpeterson299711@direct.sw.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1265403638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CENTRAL TEXAS EXPY STE 117",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765481888",
            "telephone_number": "254-457-4432",
            "fax_number": "254-618-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CENTRAL TEXAS EXPY STE 117",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765481888",
            "telephone_number": "254-457-4432",
            "fax_number": "254-618-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DALLAS",
        "middle_name": "ELWOOD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R4764",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "23268",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "315441",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harker Heights, TX

Sources for this page

Verify at the official NPI Registry.