Lookup NPI Numbers from the NPI Registry
NPI Profile for GLEN R PETTENGER in CENTERVILLE, TX.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI # | 1801910609 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 03/19/2007 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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GLEN R PETTENGER
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GLEN R PETTENGER, PA-C