Active NPI
Kylie Brooke Peterson, MD
- Anesthesiology Physician
- Houston, TX
National Provider Identifier
1720720097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- W4928
- Practice address
- 6431 Fannin St # 5.170
Houston, TX 77030-1501 - Phone
- (713) 500-7160
- Fax
- (713) 500-0648
- NPI assigned
- Apr 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | W4928 | TX | Primary |
Addresses
Primary practice location
6431 Fannin St # 5.170
Houston, TX 77030-1501
Mailing address
6411 Fannin St Ste 5.020
Houston, TX 77030-1501
Phone (713) 500-7160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781481600000",
"number": "1720720097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6411 FANNIN ST STE 5.020",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770301501",
"telephone_number": "713-500-7160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6431 FANNIN ST # 5.170",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770301501",
"telephone_number": "713-500-7160",
"fax_number": "713-500-0648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "KYLIE",
"middle_name": "BROOKE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-08",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "W4928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.