Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Glen Ross Pettenger, PA-C

Individual provider Medical Physician Assistant · NPI 1801910609

Mr. Glen Ross Pettenger, PA-C is a Medical Physician Assistant in Centerville, Texas. Licensed in Texas. Registered with an NPI since 2007.

Licensed in
TX
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

102 W Main St
Centerville, TX 75833
Phone: (903) 536-2313
Fax: (903) 536-2207
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA00952 (TX)

Record details

NPI number1801910609
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 19, 2007
Last updated in NPPESJuly 8, 2007