Petty, Leonora K

Petty, Leonora K is an individual health care provider with primary practice located at 2750 S 8Th St , Beaumont TX 77701-7719. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Petty, Leonora K can be contacted via phone (409) 839-1000.

Contact Information

Primary practice address
2750 S 8Th St Beaumont TX 77701-7719
Phone: (409) 839-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 20578 Mississippi
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X MD035524L Pennsylvania
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X P6242 Texas

Profile Details

NPI number 1194778894
LBN Legal business name Petty, Leonora K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Apr 20th, 2022 - about 3 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194778894 NPPES
Mississippi Other 302I269052 MEDICARE
Mississippi MEDICAID 109062 MEDICARE
Mississippi MEDICAID 04428702 MEDICARE
Mississippi MEDICAID 1014016060001 MEDICARE

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