Peter a Bidwell Family Practice

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

FO386 Issued in TX

Legal business name

PETER A BIDWELL FAMILY PRACTICE

Practice address

1007 Dickerson Dr
Jasper, TX 75951-5110

Phone

(409) 384-3421

Fax

(409) 384-7443

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Peter A Bidwell, MDNPI 1487650420

Title

Owner

Phone

(409) 384-3421

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Alexander Bidwell, MD

  • Family Medicine Physician
  • Jasper, TX
  • NPI 1487650420
  NPD Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1548483589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 DICKERSON DR",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759515110",
            "telephone_number": "409-384-3421",
            "fax_number": "409-384-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 DICKERSON DR",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759515110",
            "telephone_number": "409-384-3421",
            "fax_number": "409-384-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER A BIDWELL FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "BIDWELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-384-3421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "FO386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0046QP",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Jasper, TX
• Providers in Jasper, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.