Provider Demographics
NPI:1306014279
Name:GALLEGOS, NANCY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:
Last Name:GALLEGOS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1087 EVARISTO GONZALEZ W
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:TX
Mailing Address - Zip Code:78516-1532
Mailing Address - Country:US
Mailing Address - Phone:956-472-2615
Mailing Address - Fax:
Practice Address - Street 1:1087 EVARISTO GONZALEZ W
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-1532
Practice Address - Country:US
Practice Address - Phone:956-472-2615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102116OtherSTATE BOARD OF EXAMINERS FOR SPEECH LANGUAGE PATHOLOGY & AUDIOLOGY