DR. RUSSELL SCOTT PETERSEN DO NPI 1073206439

NPI Information

  • NPI: 1073206439
  • Provider Name: DR. RUSSELL SCOTT PETERSEN, DO
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • Address: 2630 BISSONNET ST APT 2405
    HOUSTON, TX
    ZIP 77005
  • Phone: (801) 588-9525

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NPI Details

DR. Russell Scott Petersen, DO is a student in an organized health care education training program in Houston, TX. The provider is 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. DR. Russell Scott Petersen, DO NPI is 1073206439. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2630 BISSONNET ST APT 2405
HOUSTON, TX
ZIP 77005-373
Phone: (801) 588-9525

The enumeration date for this NPI number is 5/31/2023 and was last updated on 5/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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