Provider Demographics
NPI:1053080846
Name:GEORGE, MICHAEL GARRETT (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GARRETT
Last Name:GEORGE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2949 FURNEAUX LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5328
Mailing Address - Country:US
Mailing Address - Phone:214-934-5290
Mailing Address - Fax:
Practice Address - Street 1:1933 E FRANKFORD RD STE 110
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5371
Practice Address - Country:US
Practice Address - Phone:972-394-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1350558225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist