Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 1295371 | TX |
NPI | 1154955300 |
---|---|
Provider Name | Dr. Thomas Wade Garrett |
First Address | The Woodlands, TX 77380-3483 |
Second Address | The Woodlands, TX 77380-3483 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2020 |
Last Update Date | 26/02/2020 |