MEDICARE: TAMBRA R GARRETT M.D.

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	207Q00000X	Family Medicine Physician	K5040	TX

General Provider Information

NPI Number	:	1922085711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMBRA R GARRETT M.D.

Provider Business Mailing Address
First Line	:	12660 COIT RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-1704
Country	:	US
Telephone Number	:	214-643-8665
Fax Number	:

Provider Business Practice Location Address
First Line	:	5775 FM 423
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75036-8956
Country	:	US
Telephone Number	:	972-525-9900
Fax Number	:	469-333-7988

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	01/26/2023

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