Provider Demographics
NPI:1790941060
Name:GARRETT, RAY WILSON JR (RT)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:WILSON
Last Name:GARRETT
Suffix:JR
Gender:M
Credentials:RT
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Mailing Address - Street 1:2334 W BUCKINGHAM RD STE 230
Mailing Address - Street 2:PMB 141
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-3971
Mailing Address - Country:US
Mailing Address - Phone:972-442-9927
Mailing Address - Fax:972-442-6415
Practice Address - Street 1:6560 FANNIN ST STE 1554
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2714
Practice Address - Country:US
Practice Address - Phone:281-851-0282
Practice Address - Fax:972-442-6415
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTUV04Medicare PIN