Provider Demographics
NPI:1164699286
Name:GALLAGHER, MAUREEN (RPH)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 WILLIAMS DR STE 3
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-3261
Mailing Address - Country:US
Mailing Address - Phone:512-863-5579
Mailing Address - Fax:512-869-8886
Practice Address - Street 1:2411 WILLIAMS DR STE 3
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3261
Practice Address - Country:US
Practice Address - Phone:512-863-5579
Practice Address - Fax:512-869-8886
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist