Provider Demographics
NPI:1871865493
Name:GALLAGHER, BRIAN JOSEPH (DPT)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14501 COMPASS ST
Mailing Address - Street 2:APT 111
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6183
Mailing Address - Country:US
Mailing Address - Phone:361-826-5779
Mailing Address - Fax:361-826-7354
Practice Address - Street 1:6130 PARKWAY
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2455
Practice Address - Country:US
Practice Address - Phone:361-826-5779
Practice Address - Fax:361-826-7354
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1213886225100000X
OH013539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist