Provider Demographics
NPI:1023051943
Name:GARRETT, JOE (RPH)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:GARRETT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 OAK DR S
Mailing Address - Street 2:SUITE M
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5629
Mailing Address - Country:US
Mailing Address - Phone:979-297-1776
Mailing Address - Fax:
Practice Address - Street 1:215 OAK DR S
Practice Address - Street 2:SUITE M
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5629
Practice Address - Country:US
Practice Address - Phone:979-297-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist