Individual
CURTIS A. PETTAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G7096
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103264101
—
TX
01
—
340008465
RR MEDICARE
TX
01
—
82M164
BCBS
TX
Enumeration date
09/15/2006
Last updated
08/06/2012
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