TREY COLIN PETTY (NPI# 1336476514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336476514 |
| Entity Type | Individual |
| Full Name | TREY COLIN PETTY |
| Credential | R.T.(R) |
| Practice Address |
4508 37th St Lubbock TX 79414-2615 |
| Practice Telephone | 8067788017 |
| Mailing Telephone | 8067788017 |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2009-11-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
R-3058 | HI | Technologists, Technicians & Other Technical Service Providers |
| N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
RHF 96247 | CA | Technologists, Technicians & Other Technical Service Providers |
| N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
RT 00007061 | WA | Technologists, Technicians & Other Technical Service Providers |
| Y | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
23364 | TX | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
4508 37TH ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79414-2615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275182032 | Ensight Vision LLC | Optometrist | 6002 Slide Road, Lubbock, TX 79414 | 2019-09-05 |
| 1932697604 | Lone Star Mobile Med | Family Medicine | 5504 Wayne Ave Ste 105, Lubbock, TX 79414 | 2018-04-27 |
| 1679986806 | Nicole Evans-taylor | Pharmacist | 4847 Slide Road, Lubbock, TX 79414 | 2014-06-05 |
| 1679911697 | Jamel Deshane Vaughn | Optometrist | 6002 Slide Rd Ste P-8, Lubbock, TX 79414 | 2013-06-12 |
| 1659663284 | Vision One Associates | Optometrist | 6221 Slide Road, Lubbock, TX 79414 | 2011-05-16 |
| 1154445963 | C M Davis Od Pllc | Optometrist | 6002 Slide Road Suite P-8, Lubbock, TX 79414 | 2007-03-19 |
| 1922154632 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 5602 Slide Road, Lubbock, TX 79414 | 2007-01-26 |
| 1043393846 | Emily Rose Bohn | Physical Therapist | 3501 S. Loop 289, Lubbock, TX 79414 | 2006-10-23 |
| 1720176928 | Vann Alexander Home Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 5313 50th Street, Suite D-5, Lubbock, TX 79414 | 2006-10-11 |
| 1952499279 | Bradley Derl Brooks | Dentist | 5301 50th Street #200, Lubbock, TX 79414 | 2006-10-11 |
| Find all providers in zip 79414 | ||||
| Taxonomy Code | 2471C3402X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Radiography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013484286 | Anissa Dusenberry | Radiologic Technologist | 8702 17th St, Lubbock, TX 79416-1930 | 2018-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842980 | Brandi Bentley | Radiologic Technologist | 10605 Camillia Blossom Ln, Austin, TX 78748-3009 | 2020-05-14 |
| 1013480961 | Eclipse Massage Therapy | Radiologic Technologist | 4321 Center St., Deer Park, TX 77536 | 2019-01-03 |
| 1538529946 | Christopher Smith | Radiologic Technologist | 3600 W Loop 250 N Apt 1059, Midland, TX 79707-3437 | 2016-02-26 |
| 1417222159 | Gina Bernal | Radiologic Technologist | 1022 Huey, Corpus Christi, TX 78418-1606 | 2012-03-13 |
| 1609031897 | Julio Morales Maldonado | Radiologic Technologist | 2403 Naomi St, Unit 12, Houston, TX 77054-4022 | 2008-07-28 |
| 1972763662 | Sergio Garcia | Radiologic Technologist | 618 W 12th St, Weslaco, TX 78596-7408 | 2008-06-16 |
| 1942460985 | Vanessa Kay Magness | Radiologic Technologist | 774 Airway Ave, Tyler, TX 75704-7806 | 2008-06-12 |
| 1598959355 | Kanu Kanu Nwankwo | Radiologic Technologist | 11311 Bayou Place Ln, Houston, TX 77099-4243 | 2007-09-04 |
| 1174720502 | Bhawna Oberoi | Radiologic Technologist | 6002 Tamsworth Ct, Allen, TX 75002-5472 | 2007-06-29 |
| 1932302049 | Home Care X-ray Service, Inc. | Radiologic Technologist | 207 Buckingham Pl, Hewitt, TX 76643-4204 | 2007-06-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.