Dr Randhi Wijekularatne Peterson, MD | |
120 E Harris Ave, San Angelo, TX 76903-5904 | |
(325) 653-6741 | |
(325) 481-2166 |
Full Name | Dr Randhi Wijekularatne Peterson |
---|---|
Gender | Female |
Speciality | Hospitalist |
Location | 120 E Harris Ave, San Angelo, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831451681 | NPI | - | NPPES |
Q5902 | Other | TX | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | Q5902 (Texas) | Secondary |
208M00000X | Hospitalist | M15216 (Idaho) | Primary |
Entity Name | Shannon Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770587149 PECOS PAC ID: 0840103727 Enrollment ID: O20031222000702 |
Mailing Address | Practice Location Address |
---|---|
Dr Randhi Wijekularatne Peterson, MD Po Box 22000, San Angelo, TX 76902-7200 Ph: (325) 658-1511 | Dr Randhi Wijekularatne Peterson, MD 120 E Harris Ave, San Angelo, TX 76903-5904 Ph: (325) 653-6741 |
David Nichols, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 2018 Pulliam St, San Angelo, TX 76905 Phone: 325-659-7290 Fax: 325-659-7291 | |
Dr. Robert D. George, M.D. Hospitalist Medicare: Medicare Enrolled Practice Location: 120 E Harris Ave, San Angelo, TX 76903 Phone: 325-653-6741 Fax: 325-481-2166 | |
Karla Seline Breton, DO Hospitalist Medicare: Medicare Enrolled Practice Location: 120 E Harris Ave, San Angelo, TX 76903 Phone: 325-747-6741 |