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General NPI Number Information
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NPI Number | 1598355265
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Entity Type | Individual
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Provider Name | GARRETT MAYEAUX DC
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Gender | Male
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 550 INDUSTRY WAY UNIT 40
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City | PROSPER
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State | TX
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Zip | 75078-2380
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Country | US
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Telephone | 469-919-6299
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Fax |
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Provider Business Mailing Address
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Address Line | 2935 HUDSON BLVD APT 227
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City | THE COLONY
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State | TX
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Zip | 75056-4872
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Country | US
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Telephone | 903-576-5864
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14647
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License Number State | TX
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