Glenn G Petty is a Podiatrist in Texarkana, Texas. Glenn G Petty practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for Glenn G Petty is 1104861160. The last update date is 2008-08-05.
Glenn G Petty's current location address is 5510 Summerhill Rd, Texarkana, Texas. You can contact this provider via phone number 9037922710 and fax number 9038317357. The mailing address for Glenn G Petty is 5510 Summerhill Rd, Texarkana, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Glenn G Petty |
|---|---|
| Address | 5510 Summerhill Rd, Texarkana, Texas |
| Phone Number | 9037922710 |
| Fax Number | 9038317357 |
| Sole Proprietor | Y |
| Credentials | D.P.M. |
NPI Number Detail
| NPI Number | 1104861160 |
|---|---|
| Provider Enumeration Date | 2006-06-16 |
| Last Updated Date | 2008-08-05 |
Provider Mailing Address Detail
| Address | 5510 Summerhill Rd |
|---|---|
| City | Texarkana |
| State | Texas (TX) |
| Post Code | 755031822 |
| Phone Number | 9037922710 |
| Fax Number | 9038317357 |
Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
|---|---|
| Taxonomy | 213E00000X |
| Licence No | 180 |
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Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 18576101 | TX | -- | |
| P00349253 | TX | RAILROAD-TX | |
| 134175717 | AR | -- | |
| P00129576 | AR | RAILROAD-AR |
Post Comment/ Review Below
What is the unique provider identifier assigned to Glenn G Petty?
The Glenn G Petty has been issued the NPI (National Provider Identifier) 1104861160 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Glenn G Petty is physically located?
The Glenn G Petty is situated at the following address: 5510 Summerhill Rd, Texarkana, TX 755031822.
What is Glenn G Petty's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Glenn G Petty is Podiatrist, and the taxonomy code that classifies this field of practice is 213E00000X.
On what date did Glenn G Petty receive its 1104861160 assignment from the Centers for Medicare & Medicaid Services?
The Glenn G Petty was assigned its 1104861160 on 2006-06-16, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Glenn G Petty, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Glenn G Petty, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2008-08-05.