MEDICARE: DR. GREGORY DALE GARLETT D.C.

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	111N00000X	Chiropractor	9311	TX

General Provider Information

NPI Number	:	1740283134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY DALE GARLETT D.C.

Provider Business Mailing Address
First Line	:	1200 KELLER PKWY
Second Line	:	STE 300
City	:	KELLER
State	:	TX
Zip	:	76248-3819
Country	:	US
Telephone Number	:	682-593-7659
Fax Number	:	682-593-7651

Provider Business Practice Location Address
First Line	:	1200 KELLER PKWY
Second Line	:	STE 300
City	:	KELLER
State	:	TX
Zip	:	76248-3819
Country	:	US
Telephone Number	:	682-593-7659
Fax Number	:	682-593-7651

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	05/11/2021

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