MEDICARE: DR. SHAUN PETER GARFF D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	Q5189	TX

General Provider Information

NPI Number	:	1093135816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAUN PETER GARFF D.O.

Provider Business Mailing Address
First Line	:	4560 LAKE RIDGE PARKWAY
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75052-3460
Country	:	US
Telephone Number	:	214-278-5000
Fax Number	:	214-278-5001

Provider Business Practice Location Address
First Line	:	4560 LAKE RIDGE PARKWAY
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75052-3460
Country	:	US
Telephone Number	:	214-278-5000
Fax Number	:	214-278-5001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2014
Last Update Date	:	12/14/2018

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