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
Mailing address12356 Riata Trace Pkwy # 6006-B, Austin, TX 78727-6417

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