Provider Demographics
NPI:1215384268
Name:ANDERSON GALLIGHER, JILLIAN (RD,CNSC,LD)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:ANDERSON GALLIGHER
Suffix:
Gender:F
Credentials:RD,CNSC,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 BARROW GLEN LOOP
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-3620
Mailing Address - Country:US
Mailing Address - Phone:412-370-8571
Mailing Address - Fax:512-852-6691
Practice Address - Street 1:7500 RIALTO BLVD
Practice Address - Street 2:STE 250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8531
Practice Address - Country:US
Practice Address - Phone:512-608-4054
Practice Address - Fax:512-852-6691
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82908133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered