Individual provider Active NPI

Dorothy Carol Pettigrew, PSY. D

  • Psychologist
  • Houston, TX
National Provider Identifier
1902915705
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
22570 Issued in TX
Practice address
4615 Southwest Fwy Ste 430
Houston, TX 77027-7114
Phone
(713) 218-6855
Fax
(713) 218-6983
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 22570 TX Primary

Addresses

Primary practice location

4615 Southwest Fwy Ste 430
Houston, TX 77027-7114

Mailing address

PO Box 310035
Houston, TX 77231-0035

Other identifiers 1

IdentifierTypeStateIssuer
1000457-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100720000837 TX Practitioner - Clinical Psychologist 8921130378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4615 Southwest Fwy
Suite 430
Houston, TX 77027-7114
Phone (713) 218-6855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22570TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dorothy C Pettigrew PSYD PC CurrentSince Mar 5, 2010 Accepting new patients

Locations

4615 Southwest Fwy
Ste 430
Houston, TX 77027
Phone (713) 218-6855

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1902915705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310035",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772310035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 SOUTHWEST FWY STE 430",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277114",
            "telephone_number": "713-218-6855",
            "fax_number": "713-218-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "DOROTHY",
        "middle_name": "CAROL",
        "credential": "PSY. D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "22570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000457-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.