Provider Demographics
NPI:1336340983
Name:GALLEGOS, ANGELA MARIA (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARIA
Last Name:GALLEGOS
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 SARATOGA BLVD APT 17
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2829
Mailing Address - Country:US
Mailing Address - Phone:361-994-5056
Mailing Address - Fax:
Practice Address - Street 1:5430 SARATOGA BLVD APT 17
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2829
Practice Address - Country:US
Practice Address - Phone:361-994-5056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19918235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist