Provider Demographics
NPI:1124190863
Name:WALD, PETER HAROLD (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:HAROLD
Last Name:WALD
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 FREDERICKSBERG RD
Mailing Address - Street 2:UNIT 03579
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78288
Mailing Address - Country:US
Mailing Address - Phone:210-498-7620
Mailing Address - Fax:
Practice Address - Street 1:9800 FREDERICKSBURG RD
Practice Address - Street 2:UNIT 03579
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78288-0001
Practice Address - Country:US
Practice Address - Phone:210-498-7620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL89982083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine