Provider Demographics
NPI:1477118891
Name:GALLAGHER, CORY PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:PATRICK
Last Name:GALLAGHER
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 1:1518 LEGACY DR STE 280
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6042
Mailing Address - Country:US
Mailing Address - Phone:214-775-9953
Mailing Address - Fax:214-775-9953
Practice Address - Street 1:1518 LEGACY DR STE 280
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6042
Practice Address - Country:US
Practice Address - Phone:214-775-9953
Practice Address - Fax:214-775-9953
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor