Provider Demographics
NPI:1366493454
Name:GAROS, SHEILA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:GAROS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10509 GARY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-6052
Mailing Address - Country:US
Mailing Address - Phone:806-535-7050
Mailing Address - Fax:806-745-7920
Practice Address - Street 1:10509 GARY AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-6052
Practice Address - Country:US
Practice Address - Phone:806-535-7050
Practice Address - Fax:806-745-7920
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31737103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0064JZOtherBLUE CROSS BLUE SHIELD
TX00914FMedicare ID - Type Unspecified
TX0064JZOtherBLUE CROSS BLUE SHIELD