Provider Demographics
NPI:1801049796
Name:PETCH, CARMELIA C (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CARMELIA
Middle Name:C
Last Name:PETCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:400 N GARFIELD ST.
Mailing Address - Street 2:SUITE 240
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5908
Mailing Address - Country:US
Mailing Address - Phone:432-683-2723
Mailing Address - Fax:432-683-4907
Practice Address - Street 1:400 N GARFIELD ST.
Practice Address - Street 2:SUITE 240
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5908
Practice Address - Country:US
Practice Address - Phone:432-683-2723
Practice Address - Fax:432-683-4907
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA05935363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant