Provider Demographics
NPI:1295704401
Name:GALLAWAY, STEVEN B (RN, FNP, BC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:GALLAWAY
Suffix:
Gender:M
Credentials:RN, FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6300 WEST PARKER ROAD
Mailing Address - Street 2:SUITE 125, MOB II
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:469-800-4400
Mailing Address - Fax:469-800-4410
Practice Address - Street 1:6300 WEST PARKER ROAD
Practice Address - Street 2:SUITE 125, MOB II
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:469-800-4400
Practice Address - Fax:469-800-4410
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX824908363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3069254-01Medicaid
TXTXB162429Medicare PIN