=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962353714
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GARRETT WHITAKER
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2026
-----------------------------------------------------
Last Update Date | 02/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3044 OLD DENTON RD STE 121
-----------------------------------------------------
City | CARROLLTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75007-5099
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-702-8208
-----------------------------------------------------
Fax | 806-785-4327
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5303 50TH ST
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79414-1817
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-702-8208
-----------------------------------------------------
Fax | 806-785-4327
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | 81191
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------