Provider Demographics
NPI:1083874549
Name:GARRETT, PAT L
Entity Type:Individual
Prefix:
First Name:PAT
Middle Name:L
Last Name:GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 N 1ST ST
Mailing Address - Street 2:105-240
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6200
Mailing Address - Country:US
Mailing Address - Phone:559-431-6798
Mailing Address - Fax:559-431-5913
Practice Address - Street 1:5730 N 1ST ST
Practice Address - Street 2:105-240
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6200
Practice Address - Country:US
Practice Address - Phone:559-431-6798
Practice Address - Fax:559-431-5913
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor