Provider Demographics
NPI:1972146603
Name:GALLAGHER, MARTINA (PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARTINA
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PROGRESSIVE BEHAVIORAL HEALTH
Mailing Address - Street 2:3355 W. ALABAMA, STE 195
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098
Mailing Address - Country:US
Mailing Address - Phone:844-824-8775
Mailing Address - Fax:
Practice Address - Street 1:3355 W ALABAMA ST STE 195
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1722
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144519363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health