Provider Demographics
NPI:1619960069
Name:GALLEGOS, FRANK V JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:V
Last Name:GALLEGOS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1900 HOT SPRINGS BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-3480
Mailing Address - Country:US
Mailing Address - Phone:505-425-3718
Mailing Address - Fax:505-425-3748
Practice Address - Street 1:3031 HOT SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4120
Practice Address - Country:US
Practice Address - Phone:505-425-6788
Practice Address - Fax:505-425-5408
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2010-04-09
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Provider Licenses
StateLicense IDTaxonomies
NM90-42207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM25551Medicaid
NME71494Medicare UPIN