Provider Demographics
NPI:1114199536
Name:CORRIGAN-GARRETT, NICOLE JULIA (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:JULIA
Last Name:CORRIGAN-GARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7859 WALNUT HILL LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-5605
Mailing Address - Country:US
Mailing Address - Phone:214-369-7661
Mailing Address - Fax:214-369-2328
Practice Address - Street 1:7859 WALNUT HILL LN
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-5605
Practice Address - Country:US
Practice Address - Phone:214-369-7661
Practice Address - Fax:214-369-2328
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN91962080P0204X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX284686701Medicaid
TX284686701Medicaid