Provider Demographics
NPI:1235316308
Name:GALICIA, DALIA GIOVANNA (MD)
Entity Type:Individual
Prefix:
First Name:DALIA
Middle Name:GIOVANNA
Last Name:GALICIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9433 N BEACH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6306
Mailing Address - Country:US
Mailing Address - Phone:817-428-7000
Mailing Address - Fax:817-428-7006
Practice Address - Street 1:9433 N BEACH ST STE 111
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244
Practice Address - Country:US
Practice Address - Phone:817-428-7000
Practice Address - Fax:817-428-7006
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-34565207KA0200X
TXM1688207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200673110AMedicaid
KS003768028Medicare PIN