Provider Demographics
NPI:1225271083
Name:LOUGHREY, GALEN CASTILLO (MD)
Entity Type:Individual
Prefix:DR
First Name:GALEN
Middle Name:CASTILLO
Last Name:LOUGHREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6900 GONZALES RD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121
Mailing Address - Country:US
Mailing Address - Phone:505-831-2534
Mailing Address - Fax:505-831-4123
Practice Address - Street 1:6900 GONZALES RD SW
Practice Address - Street 2:FIRST CHOICE COMMUNITY HEALTHCARE - ALAMOSA MEDICAL
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-2401
Practice Address - Country:US
Practice Address - Phone:505-831-2534
Practice Address - Fax:505-831-4123
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2011-0622207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program