Provider Demographics
NPI:1851344006
Name:GARRETT, GUY GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:GREGORY
Last Name:GARRETT
Suffix:
Gender:M
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:PO BOX 674004
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4004
Mailing Address - Country:US
Mailing Address - Phone:585-214-1600
Mailing Address - Fax:585-214-1619
Practice Address - Street 1:2010 S BEN MERRITT DRIVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234
Practice Address - Country:US
Practice Address - Phone:940-626-2300
Practice Address - Fax:940-626-2315
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE25722085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F3275Medicare PIN
TXE21460Medicare UPIN