Dorothy C. Pettigrew, Psy.d.,pc | |
4615 Southwest Fwy 430 Houston TX 77027-7108 | |
(713) 218-6855 | |
(713) 218-6983 |
Full Name | Dorothy C. Pettigrew, Psy.d.,pc |
---|---|
Speciality | Psychologist |
Location | 4615 Southwest Fwy, Houston, Texas |
Authorized Official Name and Position | Dorothy Carol Pettigrew (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 7132186855 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dorothy C. Pettigrew, Psy.d.,pc Po Box 310035 Houston TX 77231-0035 Ph: (713) 218-6855 | Dorothy C. Pettigrew, Psy.d.,pc 4615 Southwest Fwy 430 Houston TX 77027-7108 Ph: (713) 218-6855 |
NPI Number | 1285945766 |
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Provider Enumeration Date | 06/29/2010 |
Last Update Date | 06/29/2010 |
Medicare PECOS PAC ID | 8224160676 |
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Medicare Enrollment ID | O20100720000798 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285945766 | NPI | - | NPPES |
1000457-01 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 22570 (Texas) | Primary |
Provider Name | Dorothy C Pettigrew |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1902915705 PECOS PAC ID: 8921130378 Enrollment ID: I20100720000837 |
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