Provider Demographics
NPI:1508877127
Name:GARBER, RONALD ALAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ALAN
Last Name:GARBER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 W BETHEL ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4474
Mailing Address - Country:US
Mailing Address - Phone:972-304-8032
Mailing Address - Fax:972-304-0400
Practice Address - Street 1:413 W BETHEL ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4474
Practice Address - Country:US
Practice Address - Phone:972-304-8032
Practice Address - Fax:972-304-0400
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22855103TC0700X
TX915106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJD-33Medicare ID - Type Unspecified