Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Robert Todd Petersen, DC, OPAC, ATC, LAT

Individual provider Physician Assistant · NPI 1811917172

Dr. Robert Todd Petersen, DC, OPAC, ATC, LAT is a Chiropractic in Dallas, Texas. Qualified in 2002, 24 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Texas and Utah.

Years since qualifying
24
Licensed in
TX, UT
In the registry since
2006
Specialties on file
3
What do these letters mean?
DC — Doctor of Chiropractic
A licensed chiropractor.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

3408 Milton Ave
Dallas, TX 75205-1338
Phone: (214) 739-2225
Fax: (214) 739-2228
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Physician Chiropractor (primary) Taxonomy 111NS0005X · Licence 9289 (TX)
Physician Assistant Taxonomy 363A00000X (TX)
Sports Physician Chiropractor Taxonomy 111NS0005X · Licence 5118449-1202 (UT)

Record details

NPI number1811917172
Entity typeIndividual (Type 1)
GenderMale
Credentials DC , OPAC , ATC , LAT
Sole proprietorYes
NPI enumeratedJuly 20, 2006
Last updated in NPPESOctober 30, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCHIROPRACTIC
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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