Gary Leon Petty, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

21753 Issued in TX

Practice address

1118 Barkdull St
Houston, TX 77006-6402

Phone

(281) 447-0847

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1356366504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 BISSONNET ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770051711",
            "telephone_number": "281-447-0847",
            "fax_number": "713-589-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 BARKDULL ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770066402",
            "telephone_number": "281-447-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "GARY",
        "middle_name": "LEON",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "21753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034754401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makenzie Pettit
• Nathan James Pettit, D.M.D., M.S.D.
• Deborah Pettway
• Sharon Kay Tucker Pettway, MD
• Ann K. Petty, MT-BC, NMT
• Kristi L Petty, RD
• Mary Pomeroy Petty, LPC
• Paige Petty
• Tamara K Petty, LPC
• Teneal Mercedes Petty

• Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.