Provider Demographics
NPI: | 1881816874 |
---|---|
Name: | GARRETT, JASON JAMES (DC) |
Entity type: | Individual |
Prefix: | DR |
First Name: | JASON |
Middle Name: | JAMES |
Last Name: | GARRETT |
Suffix: | |
Gender: | M |
Credentials: | DC |
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 700688 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN ANTONIO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78270-0688 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 210-318-3007 |
Mailing Address - Fax: | 210-468-0682 |
Practice Address - Street 1: | 111 TOWER DR BLDG 1 |
Practice Address - Street 2: | |
Practice Address - City: | SAN ANTONIO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78232-3625 |
Practice Address - Country: | US |
Practice Address - Phone: | 800-404-6050 |
Practice Address - Fax: | 866-313-3397 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-05-02 |
Last Update Date: | 2023-01-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 9511 | 111NS0005X |
TX | 09511 | 111NR0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 111NR0400X | Chiropractic Providers | Chiropractor | Rehabilitation |
No | 111NS0005X | Chiropractic Providers | Chiropractor | Sports Physician |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 013453 | Other | CHIROPRACTIC LICENSE |
TN | 3107 | Other | CHIROPRACTIC LICENSE |
CA | 33637 | Other | CHIROPRACTIC LICENSE |
ID | CHIA-2052 | Other | CHIROPRACTIC LICENSE |
HI | DC-1505-0 | Other | CHIROPRACTIC LICENSE |
KS | HCSFGARRETT | Other | CHIROPRACTIC LICENSE |
IN | TS0000531 | Other | CHIROPRACTIC LICENSE |
KS | 01-06123 | Other | CHIROPRACTIC LICENSE |
AR | 16276 | Other | CHIROPRACTIC LICENSE |
AL | 2668 | Other | CHIROPRACTIC LICENSE |
AZ | 8999 | Other | CHIROPRACTIC LICENSE |
GA | CHIR010454 | Other | CHIROPRACTIC LICENSE |
ND | 1141 | Other | CHIROPRACTIC LICENSE |
LA | 1916 | Other | CHIROPRACTIC LICENSE |
SC | 4665 | Other | CHIROPRACTIC LICENSE |
NV | B01896 | Other | CHIROPRACTIC LICENSE |
DC | CH030223 | Other | CHIROPRACTIC LICENSE |
RI | DCP00685 | Other | CHIROPRACTIC LICENSE |
IL | 038.013637 | Other | CHIROPRACTIC LICENSE |
IN | 08003234A | Other | CHIROPRACTIC LICENSE |
TX | 09511 | Other | CHIROPRACTIC LICENSE |
NH | 1080 | Other | CHIROPRACTIC LICENSE |
CT | 2216 | Other | CHIROPRACTIC LICENSE |
MI | 2301011079 | Other | CHIROPRACTIC LICENSE |
FL | CH13333 | Other | CHIROPRACTIC LICENSE |
WA | CH61104769 | Other | CHIROPRACTIC LICENSE |
ME | CR2677 | Other | CHIROPRACTIC LICENSE |
NM | DC2260 | Other | CHIROPRACTIC LICENSE |
MS | 001337 | Other | CHIROPRACTIC LICENSE |
VT | 006.0134151 | Other | CHIROPRACTIC LICENSE |
IA | 105973 | Other | CHIROPRACTIC LICENSE |
UT | 11936522-1202 | Other | CHIROPRACTIC LICENSE |
MO | 2020040067 | Other | CHIROPRACTIC LICENSE |
WI | 5665-12 | Other | CHIROPRACTIC LICENSE |
MT | CHI-CHI-LIC-6710 | Other | CHIROPRACTIC LICENSE |
SD | 1405 | Other | CHIROPRACTIC LICENSE |
KY | 265421 | Other | CHIROPRACTIC LICENSE |
NC | 5245 | Other | CHIROPRACTIC LICENSE |
FL | CH10242 | Other | CHIROPRACTIC LICENSE |
CO | CHR.0006829 | Other | CHIROPRACTIC LICENSE |
VA | 0104557701 | Other | CHIROPRACTIC LICENSE |
MD | 04079 | Other | CHIROPRACTIC LICENSE |
NE | 2070 | Other | CHIROPRACTIC LICENSE |
OH | DC-05024 | Other | CHIROPRACTIC LICENSE |
MA | 3735 | Other | CHIROPRACTIC LICENSE |
OK | 3894 | Other | CHIROPRACTIC LICENSE |
NJ | 38MC00776800 | Other | CHIROPRACTIC LICENSE |
MN | 6852 | Other | CHIROPRACTIC LICENSE |
PA | DC011648 | Other | CHIROPRACTIC LICENSE |
DE | F1-0011043 | Other | CHIROPRACTIC LICENSE |