THEODORE G PETTLE — Medicare Enrolled Provider (PRACTITIONER - GASTROENTEROLOGY, TX)
THEODORE G PETTLE — Medicare Enrolled Provider (PRACTITIONER - GASTROENTEROLOGY, TX) is one of 9,000 enrolled providers in the MedicareEnroll dataset. Key details — Name: THEODORE G PETTLE; Type: Individual; NPI: 1003102211.
| Name | THEODORE G PETTLE |
|---|---|
| Type | Individual |
| NPI | 1003102211 |
| Provider type | PRACTITIONER - GASTROENTEROLOGY |
| State | TX |
| Enrollment ID | I20180702000230 |
| Multiple NPI flag | N |
| Source | CMS Medicare FFS Public Provider Enrollment (PECOS) |
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