Pettijohn, Trent Leon
Pettijohn, Trent Leon is an individual health care provider with primary practice located at 6300 W Parker Rd Mob Ii 125, Plano TX 75093-8100. He recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Pettijohn, Trent Leon can be contacted via phone (469) 800-4400.Contact Information
Primary practice address
6300 W Parker Rd Mob Ii 125
Plano TX 75093-8100
Phone: (469) 800-4400
Fax: (469) 800-4410
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | J4433 | Texas |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | J4433 | Texas |
| Allopathic & Osteopathic Physicians / Nuclear Medicine | 207U00000X | J4433 | Texas |
| Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | J4433 | Texas |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | J4433 | Texas |
Profile Details
| NPI number | 1265468706 |
|---|---|
| LBN Legal business name | Pettijohn, Trent Leon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2006 |
| Last updated | Jan 18th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265468706 | NPPES |
| Texas | Other | 8CX370 | BCBSTX |
| Texas | MEDICAID | 036498603 | BCBSTX |
| Texas | MEDICAID | 036498604 | BCBSTX |
| Texas | MEDICAID | 036498602 | BCBSTX |
| Texas | MEDICAID | 036498605 | BCBSTX |
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