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General NPI Number Information
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NPI Number | 1609898212
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Entity Type | Individual
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Provider Name | JORGE ENRIQUE GARRETT OD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 117 CIRCLE WAY ST
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City | LAKE JACKSON
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State | TX
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Zip | 77566-5233
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Country | US
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Telephone | 979-297-4042
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Fax | 979-297-4686
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Provider Business Mailing Address
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Address Line | 117 CIRCLE WAY ST
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City | LAKE JACKSON
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State | TX
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Zip | 77566-5233
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Country | US
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Telephone | 792-974-0429
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Fax | 792-974-6869
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6159TG
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License Number State | TX
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