Provider Demographics
NPI:1578684544
Name:GALINDO, ROGER M (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:M
Last Name:GALINDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 S STATE HIGHWAY 16 STE 160
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4471
Mailing Address - Country:US
Mailing Address - Phone:830-997-1303
Mailing Address - Fax:956-440-9801
Practice Address - Street 1:205 W WINDCREST ST STE 130
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4478
Practice Address - Country:US
Practice Address - Phone:830-990-1404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1854208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX414845401Medicaid
TXH08NB04301OtherBCBS