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General NPI Number Information
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NPI Number | 1568277754
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Entity Type | Individual
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Provider Name | ALYSSA GARRETT
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Gender | Female
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 213 MILL CREEK DR STE 105A
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City | SALADO
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State | TX
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Zip | 76571-6523
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Country | US
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Telephone | 254-308-2028
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Fax |
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Provider Business Mailing Address
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Address Line | 1249 DOWDY DR
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City | BELTON
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State | TX
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Zip | 76513-4167
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Country | US
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Telephone | 313-704-3646
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1404468
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License Number State | TX
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