Individual
DR. GEORGE WALTER PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11411 FM 1960 RD W, HOUSTON, TX 77065-3610
(281) 890-0792
Mailing address
15814 CASCADING BROOK WAY, CYPRESS, TX 77433-5558
(713) 253-4216
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
F9946
TX
207R00000X
Internal Medicine Physician
Primary
F9946
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8G7966
BCBSTX PROVIDER NUMBER
TX
Enumeration date
08/01/2006
Last updated
01/03/2008
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