Provider Demographics
NPI:1215276787
Name:DRISCOLL, PETER VAIL (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:VAIL
Last Name:DRISCOLL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5910 COURTYARD DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3341
Mailing Address - Country:US
Mailing Address - Phone:512-444-2274
Mailing Address - Fax:512-372-6225
Practice Address - Street 1:5910 COURTYARD DR
Practice Address - Street 2:SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3341
Practice Address - Country:US
Practice Address - Phone:512-444-2274
Practice Address - Fax:512-372-6225
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM0059207YX0007X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery