Provider Demographics
NPI:1255013165
Name:FORERO MORALES, GARRETT LEE (DPT)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:LEE
Last Name:FORERO MORALES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HARBIN AVE
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-2443
Mailing Address - Country:US
Mailing Address - Phone:469-527-5444
Mailing Address - Fax:
Practice Address - Street 1:1305 E ELM ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-2645
Practice Address - Country:US
Practice Address - Phone:254-582-2713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1255582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist