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General NPI Number Information
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NPI Number | 1295256022
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Entity Type | Individual
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Provider Name | GARRETT WILLIS NIELSON DPM
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Gender | Male
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Dates
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Enumeration Date | 07/01/2017
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 211 COMAL ST
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City | AUSTIN
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State | TX
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Zip | 78702-4326
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Country | US
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Telephone | 512-978-8130
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Fax | 512-901-9765
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Provider Business Mailing Address
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Address Line | 1111 E CESAR CHAVEZ ST
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City | AUSTIN
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State | TX
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Zip | 78702-4209
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Country | US
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Telephone | 512-978-9309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 3069
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 293
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2017022798
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License Number State | MO
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