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DR. GLENN G PETTY D.P.M.
NPI 1104861160
Podiatrist in Texarkana, TX

Active since June 16, 2006
5510 SUMMERHILL RD, TEXARKANA, TX 75503(903) 792-2710(903) 831-7357 Get Directions Write a Review

NPPES record last updated: August 5, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Glenn G Petty D.p.m. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLENN G PETTY D.P.M. (NPI 1104861160) is an individual podiatrist in Texarkana, Texas, licensed in Arkansas (180) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1104861160
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDR. GLENN G PETTYCredential: D.P.M.
Location Address5510 SUMMERHILL RDTexarkana, TX 75503-1822
Mailing AddressPo Box 6579Texarkana, TX 75505-6579 · (870) 863-7080 · Fax (903) 792-3286
Phone(903) 792-2710
Fax(903) 831-7357
Sole ProprietorYes
Enumeration DateJune 16, 2006
Last NPPES UpdateAugust 5, 2008
✔ NPI 1104861160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in AR · 180
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
5510 SUMMERHILL RD, Texarkana, TX 75503
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Other Identifiers 8

Medicaid018576101TX
Medicaid134175717AR
OtherP00129576AR · Railroad-ar
OtherP00349253TX · Railroad-tx
Medicare UPINU70771AR
Medicare PIN5T941AR
Medicare NSC6077990001
Medicare PIN00204ETX

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ORTHODOMICILE
Podiatrist
5510 SUMMERHILL RD
TEXARKANA, TX 75503
Bowie County (903) 792-2710
ELIZABETH JEAN JACOBSEN FNP-C
Nurse Practitioner (Family)
5510 SUMMERHILL RD
TEXARKANA, TX 75503
Bowie County (903) 278-9566
FELICIA MARIE COOPWOOD MSN,APRN,FNP-C
Nurse Practitioner (Family)
5510 SUMMERHILL RD
TEXARKANA, TX 75503
Bowie County (903) 556-1402

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenn Petty's NPI number?

The NPI number for Glenn Petty is 1104861160. It was assigned to this individual provider in the NPPES registry on June 16, 2006.

Where is Glenn Petty located?

Glenn Petty practices at 5510 Summerhill Rd, Texarkana, TX 75503. The listed phone number is (903) 792-2710.

What is Glenn Petty's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

When was this NPI record last updated?

The NPPES record for Glenn Petty was last updated on August 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.