Provider Demographics
NPI:1093827784
Name:GARMON, ROBERT GENE (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:GENE
Last Name:GARMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 961094
Mailing Address - Street 2:FILE 916035
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76161-0094
Mailing Address - Country:US
Mailing Address - Phone:817-599-3342
Mailing Address - Fax:817-599-3338
Practice Address - Street 1:712 E ANDERSON ST
Practice Address - Street 2:SUITE B
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5873
Practice Address - Country:US
Practice Address - Phone:817-599-3342
Practice Address - Fax:817-599-3338
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE3279207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081GGOtherBLUE CROSS PROVIDER
TX00R69SMedicare ID - Type UnspecifiedMEDICARE PROVIDER
TXA66601Medicare UPIN