Provider Demographics
NPI:1013352434
Name:GARRETT, KRISTEN VICTORIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:VICTORIA
Last Name:GARRETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:440 RAYFORD RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4168
Mailing Address - Country:US
Mailing Address - Phone:281-385-8189
Mailing Address - Fax:281-203-5037
Practice Address - Street 1:440 RAYFORD RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4168
Practice Address - Country:US
Practice Address - Phone:281-385-8189
Practice Address - Fax:281-203-5037
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA08278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant