Provider Demographics
NPI:1245452762
Name:PAUL M GARMON JR DO PA
Entity type:Organization
Organization Name:PAUL M GARMON JR DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:GARMON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:972-272-1581
Mailing Address - Street 1:2201 FOREST LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7982
Mailing Address - Country:US
Mailing Address - Phone:972-272-1581
Mailing Address - Fax:972-487-7075
Practice Address - Street 1:2201 FOREST LN
Practice Address - Street 2:SUITE 2
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7982
Practice Address - Country:US
Practice Address - Phone:972-272-1581
Practice Address - Fax:972-487-7075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00810UMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER