Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Michael Charles Petersen, MD

Individual provider Pediatrics Physician · NPI 1881798379

Dr. Michael Charles Petersen, MD is a Pediatrics Physician in Austin, Texas. Works from 2 locations. Licensed in Missouri and Texas.

Licensed in
MO, TX
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12356 Riata Trace Pkwy # 6006-B
Austin, TX 78727-6417
Phone: (512) 506-7000
Fax: (314) 251-4450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 621 S New Ballas Rd, Saint Louis, MO 63141-8232 — (314) 251-6299

Specialties & licences

Pediatric Emergency Medicine (Pediatrics) Physician (primary) Taxonomy 2080P0204X · Licence Q2049 (TX)
Pediatrics Physician Taxonomy 208000000X · Licence 2006027561 (MO)

Record details

NPI number1881798379
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 12, 2006
Last updated in NPPESSeptember 4, 2019

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