Individual provider · Type 1 NPI
Russell Scott Petersen Jr., DO
Student in an Organized Health Care Education/Training Program · Houston, TX
Practice location
2630 Bissonnet St Apt 2405
Houston, TX 77005-2373
Mailing address
6431 Fannin St Ste Jjl 310
Houston, TX 77030-1501
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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About NPI 1073206439
Russell Scott Petersen Jr., DO's National Provider Identifier is 1073206439, issued on May 31, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Houston, TX. The record was last updated on May 31, 2023.