Provider Demographics
NPI:1285276568
Name:GARNER, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GARNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 S LOOP W STE 670
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2650
Mailing Address - Country:US
Mailing Address - Phone:281-257-9061
Mailing Address - Fax:281-257-9068
Practice Address - Street 1:2626 S LOOP W STE 670
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2650
Practice Address - Country:US
Practice Address - Phone:281-257-9061
Practice Address - Fax:281-257-9068
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016097251J00000X, 253Z00000X, 343900000X, 347C00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016097OtherLICENSE