Healthcare Provider Details

I. General information

NPI: 1235365750
Provider Name (Legal Business Name): AHMAD RAHMAN GARRETT-PRICE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 GLASS ST STE 140
DALLAS TX
75207-6930
US

IV. Provider business mailing address

1505 WARREN DR
DESOTO TX
75115-6633
US

V. Phone/Fax

Practice location:
  • Phone: 866-383-6230
  • Fax: 214-433-6403
Mailing address:
  • Phone: 214-514-2288
  • Fax: 214-433-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA123927
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN9950
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: