Provider Demographics
NPI:1396859070
Name:GALLOWAY, ROBERT LEE III (RPH, DC, CCN)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:GALLOWAY
Suffix:III
Gender:M
Credentials:RPH, DC, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9410 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6211
Mailing Address - Country:US
Mailing Address - Phone:281-890-4828
Mailing Address - Fax:281-890-7721
Practice Address - Street 1:9410 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6211
Practice Address - Country:US
Practice Address - Phone:281-890-4828
Practice Address - Fax:281-890-7721
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2802111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT13377Medicare UPIN
TX601080Medicare ID - Type Unspecified