Provider Demographics
NPI:1235330416
Name:WALTER A. DEL GALLO, M.D.,P.A.
Entity Type:Organization
Organization Name:WALTER A. DEL GALLO, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEL GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-241-0324
Mailing Address - Street 1:14317 NORTHWEST BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-5536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 FLOURNOY RD
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4085
Practice Address - Country:US
Practice Address - Phone:361-664-0562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALALLEN ORTHOPAEDICS LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-29
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0710332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1270070003Medicare ID - Type UnspecifiedPALMETTO SUPPLIER NUMBER