Provider Demographics
NPI:1023826633
Name:GALLIGAN, ANNA ELIZABETH (MDS, RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:ELIZABETH
Last Name:GALLIGAN
Suffix:
Gender:F
Credentials:MDS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 BRIGHTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3313
Mailing Address - Country:US
Mailing Address - Phone:210-262-2782
Mailing Address - Fax:
Practice Address - Street 1:15303 HUEBNER RD STE 15
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-0983
Practice Address - Country:US
Practice Address - Phone:210-591-3640
Practice Address - Fax:210-209-8250
Is Sole Proprietor?:No
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86637133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered