Trey Colin Petty, R.T.(R)

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

License

23364 Issued in TX

Practice address

4508 37TH St
Lubbock, TX 79414-2615

Phone

(806) 778-8017

NPI assigned

Nov 10, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1336476514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 37TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794142615",
            "telephone_number": "806-778-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 37TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794142615",
            "telephone_number": "806-778-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "TREY",
        "middle_name": "COLIN",
        "credential": "R.T.(R)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "TX",
            "license": "23364",
            "primary": true
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "WA",
            "license": "RT 00007061",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "CA",
            "license": "RHF 96247",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "HI",
            "license": "R-3058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrin Odell Peterson, O.D.
• Jayman Disean Peterson, DPT
• Phyllis Rose Peterson, PA
• Ailyn Petit Hanke, HIS
• Kyla Petrie, MD
• Derek Pfeiffer, DPT
• Pforym Business Solutions, Inc (pforymWELL)
• Doanh K Phan, MD.PA.
• Pharmcare USA of Lubbock LLC (Pharmcare USA of Lubbock)
• Pharmerica Drug Systems LLC (Pharmerica)

• Radiography Radiologic Technologist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Radiography Radiologic Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.