Richard P Petri Jr., M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

S3567 Issued in TX

Practice address

6301 La Posta Dr
El Paso, TX 79912-1863

Phone

(915) 342-2088

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1962450213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 LA POSTA DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799121863",
            "telephone_number": "915-342-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 LA POSTA DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799121863",
            "telephone_number": "915-342-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRI",
        "first_name": "RICHARD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "35103",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "S3567",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "S3567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Lowell Pester, M.D.
• Peter S Herman MD PA
• David Lee Peters, LICENSED MASSAGE THE
• Jacob Petersen
• Deena G. Peterson, SLP
• Philippe William Petrus, PA-C
• Jena Lynette Petry, RN, MSN,NNP
• Grace Petrykowski
• Nanette Burfield Pettry, CRNP
• Stephen Petty, D.D.S

• General Practice Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.