Edward Walter Pettyjohn, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

S1430 Issued in TX

Practice address

9110 N Loop 1604 W Ste 104
San Antonio, TX 78249-3397

Phone

(210) 802-7007

NPI assigned

Aug 3, 2013

Last updated

May 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1375488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1801228630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15311 ESCARPMENT OAK",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780235155",
            "telephone_number": "770-653-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 N LOOP 1604 W STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493397",
            "telephone_number": "210-802-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTYJOHN",
        "first_name": "EDWARD",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-03",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "S1430",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "S1430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400888001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Dee Pettit
• Catherine Marie Petty, MS, CCC SLP
• Don Ray Petty, DDS
• Jasmine Petty
• Kayla Petty
• Hazel Pevehouse
• Cody Joel Pewarchuk, DMD
• Larissa Pexton
• Samin Pezeshk, O.D.
• Alizay Ravae Pezza

• Orthopaedic Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.