MEDICARE: ROBERT GARRETT DC

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	111N00000X	Chiropractor	7373	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8A7591	OTHER	TX	BLUE CROSS/BLUE SHEILD

General Provider Information

NPI Number	:	1740236074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT GARRETT DC

Provider Business Mailing Address
First Line	:	4747 S HULEN ST
Second Line	:	SUITE 101
City	:	FT WORTH
State	:	TX
Zip	:	76132
Country	:	US
Telephone Number	:	817-292-3553
Fax Number	:	817-292-2575

Provider Business Practice Location Address
First Line	:	4747 S HULEN ST
Second Line	:	SUITE 101
City	:	FT WORTH
State	:	TX
Zip	:	76132
Country	:	US
Telephone Number	:	817-292-3553
Fax Number	:	817-292-2575

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/26/2008

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Directions to “ ROBERT GARRETT DC” Practice Location

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