Basic Information
Provider Information
NPI: 1245551803
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: PETER
MiddleName: DAVID
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 2146483916
FaxNumber: 2146488423
Practice Location
Address1: 5323 HARRY HINES BOULEVARD
Address2:  
City: DALLAS
State: TX
PostalCode: 753907208
CountryCode: US
TelephoneNumber: 2146483916
FaxNumber: 2146488423
Other Information
ProviderEnumerationDate: 06/17/2010
LastUpdateDate: 10/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XQ2687TXY Allopathic & Osteopathic PhysiciansEmergency Medicine 
390200000X MON Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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