WALTER RUSSELL PETERS JR. (NPI# 1316941123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316941123 |
| Entity Type | Individual |
| Full Name | WALTER RUSSELL PETERS JR. |
| Credential | M.D., M.B.A |
| Practice Address |
3409 Worth St Worth Tower, Suite 640 Dallas TX 75246-2029 |
| Practice Telephone | 4698007180 |
| Practice Fax Number | 4698007190 |
| Mailing Telephone | 4698007180 |
| Mailing Fax Number | 4698007190 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2017-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | R6G45 | MO | Allopathic & Osteopathic Physicians |
| Y | 208C00000X | Colon & Rectal Surgery | Q6358 | TX | Allopathic & Osteopathic Physicians |
| N | 208C00000X | Colon & Rectal Surgery | R6G45 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 202523015 | 05 | |
| MO | PHCS | 123497 | 01 |
| MO | UNITED HEALTHCARE | 1284609 | 01 |
| MO | ANTHEM BLUECROSS BLUESHIE | 25055 | 01 |
| TX | AETNA | 4343317 | 01 |
| TX | 3548646-01 | 05 | |
| MO | HEALTHCARE USA | 5125 | 01 |
| TX | BCBS | 8FM794 | 01 |
| MO | GHP | 28058 | 01 |
| MO | GREAT WEST | 431428562 | 01 |
| MO | MERCY | A10787 | 01 |
| TX | NPI | 1316941123 | 01 |
| MO | AETNA | 4343317 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245258789 | Walter James Peters Jr. | Ophthalmology | 7171 S Yale Ave Ste 101, Tulsa, OK 74136-6367 | 2006-07-17 |
| 1104857598 | Walter J Peters | Internal Medicine | 233 Christie Dr, Martinez, CA 94553-5713 | 2006-07-05 |
| 1831362037 | Walter Hamilton Peters Iv | Psychiatry & Neurology | 8 Richland Medical Park, Suite 420, Columbia, SC 29203-8004 | 2008-04-08 |
| Street Address |
3409 WORTH ST WORTH TOWER, SUITE 640 |
| City | DALLAS |
| State | TX |
| Zip Code | 75246-2029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528507951 | John Mitchell | Pharmacist | 3409 Worth St, Suite 725, Dallas, TX 75246-2029 | 2017-02-17 |
| 1992259931 | Leonor Sosa | Nurse Practitioner | 3409 Worth St, Suite 600, Dallas, TX 75246-2029 | 2016-08-08 |
| 1861870081 | Clayton Bates | Specialist/Technologist, Other | 3409 Worth St, Ste 725, Dallas, TX 75246-2029 | 2015-05-07 |
| 1457789265 | Texas Spine Consultants, LLP | Pain Medicine | 3409 Worth St, Suite 510, Dallas, TX 75246-2029 | 2013-10-15 |
| 1336572494 | Tammara J Verduin | Specialist/Technologist, Other | 3409 Worth St, Suite 630, Dallas, TX 75246-2029 | 2013-08-13 |
| 1669796322 | Katerina Olivia Kimonis Wells | Colon & Rectal Surgery | 3409 Worth St, Suite 500, Dallas, TX 75246-2029 | 2010-03-23 |
| 1871733188 | Clinton Christopher Haley | Internal Medicine | 3409 Worth St, Suite 710, Dallas, TX 75246-2029 | 2009-02-26 |
| 1356512370 | David E Morales M D P A | Specialist | 3409 Worth St, Suite 630, Dallas, TX 75246-2025 | 2008-03-18 |
| 1154592186 | William M Carpenter Md Pa | Specialist | 3409 Worth St, Suite 630, Dallas, TX 75246-2025 | 2008-03-18 |
| 1528244431 | Watson Anonetapipat | Perfusionist | 3409 Worth St, Suite 725, Dallas, TX 75246-2029 | 2008-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396201356 | Roseann Estrada Mendoza | Nurse Practitioner | 3600 Gaston Ave., Barnett Tower, Suite 711, Dallas, TX 75246 | 2019-02-14 |
| 1033683701 | Marta Revilla-leon | Dentist | 3302 Gaston Avenue, College of Dentistry, Texas A&m Uni, Room 713, Dallas, TX 75246 | 2019-01-16 |
| 1912408170 | Liza Johannesson | Transplant Surgery | Baylor University Medical Center, 3410 Worth Street, Ste 950, Dallas, TX 75246 | 2018-02-23 |
| 1841710266 | Stephanie Chartier-plante | Student in an Organized Health Care Education/Training Program | 3501 Junius St, Jonsson Hospital, Dallas, TX 75246 | 2017-06-27 |
| 1528505096 | Adam Bohnenblust | Chiropractor | 411 N Washington Ave Ste 2200, Dallas, TX 75246 | 2017-01-23 |
| 1699121327 | Magnolia Pain Associates Pllc | Pain Medicine | 3801 Gaston Ave Ste 318- 320, Dallas, TX 75246 | 2016-05-12 |
| 1073969408 | Apurva Yeluru | Hospitalist | 3500 Gaston Ave Ste 550, Dallas, TX 75246 | 2016-05-04 |
| 1134580533 | Sp Alf Ops Co, LLC | Assisted Living Facility | 3922 Simpson Street, Dallas, TX 75246 | 2016-03-11 |
| 1386031185 | Lisa Voigt | Student in an Organized Health Care Education/Training Program | 3501 Junius Street, Dallas, TX 75246 | 2015-04-20 |
| 1891107843 | Jessica Shie | Internal Medicine | Baylor Scott & White - Hospital Medicine Dallas, 3600 Gaston Ave., Wadley #550, Dallas, TX 75246 | 2014-05-27 |
| Find all providers in zip 75246 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225272198 | Trinity Colon and Rectal Surgery Clinic, Pa | Colon & Rectal Surgery | 8067 West Virginia Drive, Dallas, TX 75237 | 2009-04-23 |
| 1114110756 | David S. Pita | Colon & Rectal Surgery | 8500 N Stemmons Fwy Ste 6077, Dallas, TX 75247-3003 | 2007-08-27 |
| 1336236819 | Farshid Y. Araghizadeh | Colon & Rectal Surgery | 1801 Inwood Road Suite Wa4.414, Dept of Surgery, Dallas, TX 75390-8819 | 2006-10-06 |
| 1154332393 | Paul Samuel Hackett | Colon & Rectal Surgery | 3450 W Wheatland Rd Ste 340, Dallas, TX 75237 | 2006-08-11 |
| 1689692105 | James W Fleshman Jr. | Colon & Rectal Surgery | 3409 Worth Street, Worth Tower, Suite 640, Dallas, TX 75246-2003 | 2006-07-17 |
| 1487693834 | Texas Colon & Rectal Surgeons, LLP | Colon & Rectal Surgery | 16980 Dallas Pkwy Ste 200, Dallas, TX 75248-1974 | 2006-06-04 |
| 1558809301 | Texas Colon & Rectal Surgeons, LLP | Colon & Rectal Surgery | 16980 Dallas Pkwy Ste 200, Dallas, TX 75248-1974 | 2017-02-01 |
| 1639617483 | Texas Colon & Rectal Surgeons, LLP | Colon & Rectal Surgery | 16980 Dallas Pkwy Ste 200, Dallas, TX 75248-1974 | 2017-02-01 |
| 1669796322 | Katerina Olivia Kimonis Wells | Colon & Rectal Surgery | 3409 Worth St, Suite 500, Dallas, TX 75246-2029 | 2010-03-23 |
| 1114110145 | Ricky D. Dignan | Colon & Rectal Surgery | 3600 Gaston Ave, Suite 1209, Dallas, TX 75246-1800 | 2007-08-22 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on WALTER RUSSELL PETERS JR..
| 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.