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Individual
RENEE DELISE PETTIS
Active
Individual
RENEE DELISE PETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07388
TX
363AM0700X
Medical Physician Assistant
247
DC
363AM0700X
Medical Physician Assistant
PA.200446
LA
363AM0700X
Medical Physician Assistant
PA07388
TX
363AM0700X
Medical Physician Assistant
PA247
DC
Other
Enumeration date
02/13/2007
Last updated
04/14/2021
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