Forest Park Peters Co, LLC

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Legal business name

FOREST PARK PETERS CO, LLC

Practice address

6125 Luther LN
#175
Dallas, TX 75225-6202

Phone

(214) 315-6432

Fax

(214) 317-4667

NPI assigned

Dec 8, 2014

Last updated

Dec 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

B Robert Peters, MD

Title

Owner

Phone

(214) 315-6432

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1407254436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6730 BRADBURY LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302836",
            "telephone_number": "214-315-6432",
            "fax_number": "214-317-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6125 LUTHER LN",
            "address_2": "#175",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752256202",
            "telephone_number": "214-315-6432",
            "fax_number": "214-317-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST PARK PETERS CO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "B ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-315-6432",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Forever Nutrition LLC

• Surgical Technologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Surgical Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.