MEDICARE: DR. JASON GLENN GARVIN D.O.

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	2084P0804X	Child & Adolescent Psychiatry Physician	L2271	TX
2	2084P0800X	Psychiatry Physician	L2271	TX

General Provider Information

NPI Number	:	1396754883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON GLENN GARVIN D.O.

Provider Business Mailing Address
First Line	:	2211 NORFOLK ST STE 740
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4062
Country	:	US
Telephone Number	:	713-337-0177
Fax Number	:	713-337-0178

Provider Business Practice Location Address
First Line	:	3000 RICHMOND AVE
Second Line	:	SUITE 425
City	:	HOUSTON
State	:	TX
Zip	:	77098-3102
Country	:	US
Telephone Number	:	713-337-0177
Fax Number	:

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/23/2025

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