Active NPI
Raurie Quinn Petrich
- Orthodontics and Dentofacial Orthopedics Dentistry
- League City, TX
National Provider Identifier
1215619184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 42204
- Practice address
- 2555 E League City Pkwy
League City, TX 77573-7107 - Phone
- (713) 346-9997
- NPI assigned
- Aug 1, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | RES.004682 | OH | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 42204 | TX | Primary |
Addresses
Primary practice location
2555 E League City Pkwy
League City, TX 77573-7107
Mailing address
2555 E League City Pkwy
League City, TX 77573-7107
Phone (810) 449-1512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RES.004682 | OH | MD | Dentist |
| 42204 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772150400000",
"number": "1215619184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2555 E LEAGUE CITY PKWY",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775737107",
"telephone_number": "810-449-1512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2555 E LEAGUE CITY PKWY",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775737107",
"telephone_number": "713-346-9997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRICH",
"first_name": "RAURIE",
"middle_name": "QUINN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-01",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "RES.004682",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "42204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in League City, TX
- Performance Pain and Sports Medicine, PLLC
- Clarissa Ava Perkins-Stafford
- Erika Jane Perry, RN, CNOR, RNFA
- Lynda Cannezzaro Peterson, MSED., LP, LCDC, NBC
- Rebecca Ann Peth, DPT
- Roman V Petrov, MD
- PF Development 7, LLC (CenterWell Home Health)
- PF Development 7, LLC (Kindrd Hospice)
- Jimmy Vinh Pham
- Julie HT Pham
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.