Provider Demographics
NPI:1699715466
Name:LOEB, PETER M (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:M
Last Name:LOEB
Suffix:
Gender:
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:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2213
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:8230 WALNUT HILL LN
Practice Address - Street 2:SUITE 610
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4482
Practice Address - Country:US
Practice Address - Phone:214-345-7398
Practice Address - Fax:214-345-4606
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2566207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ0037129OtherDPS
TX134251108Medicaid
TX8S9972OtherBCBS
TX8S9972OtherBCBS
TX8J1083Medicare PIN
TXJ0037129OtherDPS
TX8S9972OtherBCBS