Provider Demographics
NPI:1710906664
Name:GALLO, JOE P (NP)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:P
Last Name:GALLO
Suffix:
Gender:M
Credentials:NP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9229 LYNDON B JOHNSON FWY
Mailing Address - Street 2:STE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3405
Mailing Address - Country:US
Mailing Address - Phone:972-739-3097
Mailing Address - Fax:972-739-2673
Practice Address - Street 1:910 W CHAPMAN DR
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266-9061
Practice Address - Country:US
Practice Address - Phone:940-458-2044
Practice Address - Fax:940-458-2014
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX636470363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G5181Medicare ID - Type Unspecified
TXP34275Medicare UPIN