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General NPI Number Information
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NPI Number | 1154506780
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Entity Type | Organization
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Legal Business Name | TAMBRA R GARRETT MD PA
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 5870 LONG PRAIRIE RD SUITE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2282
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Country | US
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Telephone | 972-539-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 5870 LONG PRAIRIE RD SUITE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2282
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Country | US
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Telephone | 972-539-5599
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMBRA R GARRETT
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Credential | MD
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Telephone | 972-539-5599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K5040
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License Number State | TX
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