Healthcare Provider Details

I. General information

NPI: 1720917321
Provider Name (Legal Business Name): GARRETT EDWARDS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 CHERRY ST
TOLEDO OH
43608-2603
US

IV. Provider business mailing address

2205 SUMMER BREEZE RD
MISSION TX
78572-3271
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-4724
  • Fax:
Mailing address:
  • Phone: 956-607-2112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number59.001128
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: