Provider Demographics
NPI:1376642280
Name:GALLI, CARLO DAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CARLO
Middle Name:DAN
Last Name:GALLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 FALLS CT STE 500
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2982
Mailing Address - Country:US
Mailing Address - Phone:830-249-7858
Mailing Address - Fax:830-249-6850
Practice Address - Street 1:109 FALLS CT STE 500
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2982
Practice Address - Country:US
Practice Address - Phone:830-249-7858
Practice Address - Fax:830-249-6850
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX663923OtherASHN
TX8H0530OtherBLUE CROSS / BLUE SHIELD
TXP00091567OtherMEDICARE RAILROAD
TX663923OtherASHN
TXU65280Medicare UPIN