MEDICARE: DR. DANIEL RAY GARLITOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	K7742	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00250T	OTHER	TX	GROUP MEDICARE PIN
5	00251T	OTHER	TX	GROUP MEDICARE PIN
8	P00695492	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	8BP367	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1386629574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL RAY GARLITOS MD

Provider Business Mailing Address
First Line	:	100B MEDICAL DR
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5674
Country	:	US
Telephone Number	:	979-297-9268
Fax Number	:	979-297-9331

Provider Business Practice Location Address
First Line	:	100B MEDICAL DR
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5674
Country	:	US
Telephone Number	:	979-297-9268
Fax Number	:	979-297-9331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	01/23/2025

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Directions to “ DR. DANIEL RAY GARLITOS MD” Practice Location

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