Healthcare Provider Details

I. General information

NPI: 1659299295
Provider Name (Legal Business Name): REINA GARRETT OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 HAW CREEK CIR STE 100
CUMMING GA
30041-6513
US

IV. Provider business mailing address

1034 HAW CREEK CIR STE 100
CUMMING GA
30041-6513
US

V. Phone/Fax

Practice location:
  • Phone: 678-737-4616
  • Fax:
Mailing address:
  • Phone: 678-737-4616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003755
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: