Provider Demographics
NPI:1336187731
Name:BEITSCH, PETER (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:BEITSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8140 WALNUT HILL LN STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4396
Mailing Address - Country:US
Mailing Address - Phone:214-350-6672
Mailing Address - Fax:214-452-5643
Practice Address - Street 1:8140 WALNUT HILL LN STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4396
Practice Address - Country:US
Practice Address - Phone:214-350-6672
Practice Address - Fax:214-452-5643
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH22392086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138478601Medicaid
TX138478601Medicaid
D86995Medicare UPIN