MATTHEW SEAN PETITT (NPI# 1912101593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912101593 |
| Entity Type | Individual |
| Full Name | MATTHEW SEAN PETITT |
| Credential | DO |
| Practice Address |
4419 Crenshaw Rd Pasadena TX 77504-3628 |
| Practice Telephone | 2819915944 |
| Mailing Telephone | 2819915944 |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2011-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
M2750 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MYUTMB 3853003243-COMMERCIAL NUMBER | 3853003243 | 01 |
| Street Address |
4419 CRENSHAW RD |
| City | PASADENA |
| State | TX |
| Zip Code | 77504-3628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649276692 | Lawrence M. Joseph | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2005-06-23 |
| 1811331572 | Elizabeth Drone Schepp | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2013-04-24 |
| 1922393131 | Isha Lopez | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2011-06-15 |
| 1366607194 | Christine M Hunt | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2008-07-21 |
| 1346277381 | Mary Elizabeth Garman | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2006-06-26 |
| 1811932205 | Southeast Dermatology, P.a. | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2006-06-18 |
| 1316905029 | Paula F Leis | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2006-05-02 |
| 1194709626 | Manuel Davila | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2005-11-29 |
| 1760484349 | Wendy C Magee | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2005-08-12 |
| 1851392039 | Ashkan John Ghorbani | Dermatology | 4419 Crenshaw Rd, Pasadena, TX 77504-3628 | 2005-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316408149 | Caitlin Demi Valverde | Nurse Practitioner | 3412 Burke Rd Ste 100, Pasadena, TX 77504 | 2019-03-26 |
| 1780164475 | Erin Osmus | Physical Therapist | 3434 Watter, Pasadena, TX 77504 | 2018-08-21 |
| 1184117103 | Lifealysis Kidney Care, LLC | Clinic/Center | 4300 Fairmont Pkwy Ste 100, Pasadena, TX 77504 | 2018-06-13 |
| 1477044253 | Karen Colleen Watkins | Registered Nurse | 3332 Plainview Drive, Pasadena, TX 77504 | 2018-05-28 |
| 1619465192 | Morgan Pharmacy | Pharmacy | 3316 Shaver St Ste 6, Pasadena, TX 77504 | 2018-04-30 |
| 1528566890 | Assured Imaging Women's Wellness of Southern Arizona, LLC | Clinic/Center | 4008 Vista Rd. Bldg B Suite B101, Pasadena, TX 77504 | 2018-01-31 |
| 1972015022 | Oasis Mind and Body | Psychiatry & Neurology | 3301 Plainview, 1, Pasadena, TX 77504 | 2017-10-30 |
| 1629503933 | Inner City Podiatry Professional Limited Liability Company | Podiatrist | 3801 Vista Rd Ste 180, Pasadena, TX 77504 | 2017-04-24 |
| 1063952943 | Irfan Jawed Md Pllc | Internal Medicine | 4102 Woodlawn Avenue, Ste 160, Pasadena, TX 77504 | 2017-02-27 |
| 1669911707 | Quetzalli Zavala | Nurse Practitioner | 3326 Watters Rd Bldg B, Pasadena, TX 77504 | 2017-02-22 |
| Find all providers in zip 77504 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831389964 | Marilyn Ann Mehlmauer | Dermatology | 10 Congress St Ste 320, Pasadena, CA 91105-3023 | 2007-07-25 |
| 1932281888 | James Richard Esther | Dermatology | 65 North Madison Ave., Suite 409, Pasadena, CA 91101-2049 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467826131 | Medica Skin Diagnostics Pllc | Dermatology | 2046 Bedford Rd, Bedford, TX 76021-5709 | 2015-11-18 |
| 1942639455 | Dr. Samuel F Bean, Md, Pa | Dermatology | 1200 Binz St Ste 1110, Houston, TX 77004-6935 | 2013-11-05 |
| 1831417211 | Adaobi Nwaneshiudu Obasi | Dermatology | 6801 Mcpherson Rd Ste 332, Laredo, TX 78041-6417 | 2010-05-11 |
| 1366679466 | Ameripath 501a Corporation | Dermatology | 2330 Butler Street, Suite 115, Dallas, TX 75235-7800 | 2009-06-16 |
| 1104091487 | Galveston Dermatology, P.a. | Dermatology | 1501 Broadway Ave, Galveston, TX 77550 | 2008-04-28 |
| 1093865545 | Tracie Denise Swayden | Dermatology | 804 Ne Mall Blvd, Hurst, TX 76053-4653 | 2007-01-10 |
| 1265507941 | Angela Yen Moore, Md Pa | Dermatology | 711 E Lamar Blvd, Suite 200, Arlington, TX 76011-3888 | 2006-11-21 |
| 1568531739 | Melissa P Chiang | Dermatology | 5061 Fm 2920, Spring, TX 77388 | 2006-11-06 |
| 1962430108 | Andrew Marlin Morgan | Dermatology | 1001 N Twin Creek Dr, #201, Killeen, TX 76543-4268 | 2006-06-28 |
| 1245274331 | Anne E Wilkerson | Dermatology | 3010 Williams Dr, Suite 210, Georgetown, TX 78628-2764 | 2006-06-16 |
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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.