Provider Demographics
NPI:1871035147
Name:GARRETT, CHADWICK JOEL (MS, LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:CHADWICK
Middle Name:JOEL
Last Name:GARRETT
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22602 HEMPSTEAD HWY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5055
Mailing Address - Country:US
Mailing Address - Phone:281-897-4671
Mailing Address - Fax:281-517-2078
Practice Address - Street 1:22602 HEMPSTEAD HWY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5055
Practice Address - Country:US
Practice Address - Phone:281-897-4671
Practice Address - Fax:281-517-2078
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT4835174400000X
TX1029109174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist