Provider Demographics
NPI:1598355265
Name:MAYEAUX, GARRETT (DC)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:
Last Name:MAYEAUX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 HUDSON BLVD APT 227
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4872
Mailing Address - Country:US
Mailing Address - Phone:903-576-5864
Mailing Address - Fax:
Practice Address - Street 1:550 INDUSTRY WAY UNIT 40
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2380
Practice Address - Country:US
Practice Address - Phone:469-919-6299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor