Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. GLEN ROSS PETTENGER, PA-C
ActiveMR. GLEN ROSS PETTENGER, PA-C is a Medical Physician Assistant healthcare provider located in CENTERVILLE, Texas. NPI 1801910609 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · CENTERVILLE, TX
Registration Details
- NPI Number
- 1801910609
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 19, 2007 (19.448797689728 yrs)
- Last Updated
- Jul 8, 2007
- License
-
PA00952 (TX)
Practice Information
- Address
-
102 WEST MAIN STREETCENTERVILLE, TX, 75833Browse TX providers · Browse ZIP 75833
- Phone
- 9035362313
- Fax
- 9035362207
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.