Individual
GARY LEON PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1118 BARKDULL ST, HOUSTON, TX 77006-6402
(281) 447-0847
Mailing address
1815 BISSONNET ST, HOUSTON, TX 77005-1711
(281) 447-0847
(713) 589-9631
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
21753
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034754401
—
TX
Enumeration date
07/12/2006
Last updated
03/13/2009
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