Individual
DR. STEVEN MICHAEL PETAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6550 FANNIN ST, SUITE 1101, HOUSTON, TX 77030-2717
(713) 441-0006
Mailing address
6550 FANNIN ST, SUITE 1101, HOUSTON, TX 77030-2717
(713) 441-0006
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
G1147
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119141304
—
TX
05
—
119141305
—
TX
01
—
1861493157
BLUE CROSS BLUE SHIELD
TX
01
—
P01242674
MEDICARE RR
TX
Enumeration date
08/09/2005
Last updated
08/13/2014
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