Healthcare Provider Details

I. General information

NPI: 1326902198
Provider Name (Legal Business Name): MORGAN RETTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17505 MARY POLK RD
JUSTIN TX
76247-7807
US

IV. Provider business mailing address

17505 MARY POLK RD
JUSTIN TX
76247-7807
US

V. Phone/Fax

Practice location:
  • Phone: 214-930-5954
  • Fax:
Mailing address:
  • Phone: 214-930-5954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-320055
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: