MR. DARRYL W. PETERSON (NPI# 1174579874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174579874 |
| Entity Type | Individual |
| Full Name | MR. DARRYL W. PETERSON |
| Credential | MD |
| Practice Address |
2803 Earl Rudder Fwy S Ste 103 College Station TX 77845-6099 |
| Mailing Address |
2800 S Texas Ave Ste 202 Bryan TX 77802-5361 |
| Practice Telephone | 9797318888 |
| Practice Fax Number | 9797318935 |
| Mailing Telephone | 9797742061 |
| Mailing Fax Number | 9797765914 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2017-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 12182R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 370416501 | 05 | |
| LA | 1543365 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117386 | Darryl Wayne Peterson II | Counselor | 3040 Wicker St Ne, Canton, OH 44721-2298 | 2019-11-05 |
| 1760454425 | Darryl L Peterson | Physician Assistant | 600 Caisson Hill Rd, Ft Riley, KS 66442-7037 | 2006-02-06 |
| Street Address |
2803 EARL RUDDER FWY S STE 103 |
| City | COLLEGE STATION |
| State | TX |
| Zip Code | 77845-6099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174591242 | Jon C Teacle | Physician Assistant | 2803 Earl Rudder Fwy S Ste 103, College Station, TX 77845-6099 | 2006-03-14 |
| 1629137401 | Barry Lynn Veazey | Orthopaedic Surgery | 2803 Earl Rudder Fwy S Ste 103, College Station, TX 77845-6099 | 2006-12-07 |
| 1326107467 | Joseph John Iero | Orthopaedic Surgery | 2803 Earl Rudder Fwy S Ste 103, College Station, TX 77845-6099 | 2006-12-06 |
| 1942399316 | Mark B Riley | Orthopaedic Surgery | 2803 Earl Rudder Fwy S Ste 103, College Station, TX 77845-6099 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503101 | Aggieland Urgent Care Pllc | Clinic/Center | 13055 Fm 2154 Rd, College Station, TX 77845 | 2019-11-19 |
| 1770053399 | Alyssa Nicole Sanchez | Licensed Vocational Nurse | 4030 Hwy 6 S 150, College Station, TX 77845 | 2018-11-27 |
| 1154805778 | Medical Care Innovation, P.C. | Clinic/Center | 200 Quality Circle, College Station, TX 77845 | 2018-09-19 |
| 1003302530 | Kaye Lynn Tseng | Registered Nurse | 4030 Hightway 6 South, College Station, TX 77845 | 2018-07-09 |
| 1083117907 | College Station Dentistry and Orthodontics Pllc | Dentist | 11671 Fm 2154, Suite 400, College Station, TX 77845 | 2018-03-16 |
| 1912409954 | H-e-b, Lp | Clinical Medical Laboratory | 11675 Fm 2154, College Station, TX 77845 | 2018-03-06 |
| 1871095745 | Gregory Nicholas Perry | Physical Therapist | 4091 Sh 6 South, Suite B, College Station, TX 77845 | 2018-03-06 |
| 1811435639 | Michael Patke | Student in an Organized Health Care Education/Training Program | 10613 Deer Run Dr., College Station, TX 77845 | 2017-02-01 |
| 1558810473 | Sara Beth Williamson | Nurse Practitioner | 4401 State Hwy 6 S, College Station, TX 77845 | 2016-10-04 |
| 1881067379 | Kieshia Lewis | Occupational Therapy Assistant | 2700 Earl Rudder Frwy Suite 1200, College Station, TX 77845 | 2015-11-05 |
| Find all providers in zip 77845 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972828481 | Colten Christopher Luedke | Orthopaedic Surgery | 3526 Longmire Dr Ste 200, College Station, TX 77845-6472 | 2010-03-29 |
| 1528218047 | Coy A Wright | Orthopaedic Surgery | 800 Scott & White Dr, College Station, TX 77845 | 2008-09-19 |
| 1437339249 | Justin R. Brazeal | Orthopaedic Surgery | 2803 Earl Rudder Fwy S, Suite 103, College Station, TX 77845-6099 | 2007-11-08 |
| 1740239979 | Jeffrey N Spaw | Orthopaedic Surgery | 1451 Greens Prairie Rd W Ste 200, College Station, TX 77845 | 2006-05-06 |
| 1881153435 | Third Day Orthopedics & Sports Medicine Pllc | Orthopaedic Surgery | 1451 Greens Prairie Rd W Ste 200, College Station, TX 77845-8794 | 2019-03-13 |
| 1629137401 | Barry Lynn Veazey | Orthopaedic Surgery | 2803 Earl Rudder Fwy S Ste 103, College Station, TX 77845-6099 | 2006-12-07 |
| 1326107467 | Joseph John Iero | Orthopaedic Surgery | 2803 Earl Rudder Fwy S Ste 103, College Station, TX 77845-6099 | 2006-12-06 |
| 1942399316 | Mark B Riley | Orthopaedic Surgery | 2803 Earl Rudder Fwy S Ste 103, College Station, TX 77845-6099 | 2006-10-12 |
| 1215999693 | William Whiteley | Orthopaedic Surgery | 1602 Rock Prairie Rd, Ste. 460, College Station, TX 77845-8306 | 2006-04-03 |
| 1295796076 | Thomas P. Oshea | Orthopaedic Surgery | 1600 University Dr E, College Station, TX 77840-2642 | 2006-03-31 |
| Find all providers in COLLEGE STATION | ||||
| City | COLLEGE STATION |
| Zip Code | 77845 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.