Individual
GABRIEL LEWIS PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4611 GUADALUPE ST STE 200, AUSTIN, TX 78751-2928
(512) 476-2830
(512) 476-2832
Mailing address
4611 GUADALUPE ST STE 200, AUSTIN, TX 78751-2928
(512) 476-2830
(512) 476-2832
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06237
TX
363AS0400X
Surgical Physician Assistant
PA06237
TX
Other
Enumeration date
05/22/2009
Last updated
06/07/2024
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