Provider Demographics
NPI:1669167599
Name:GALLAZART PLLC
Entity type:Organization
Organization Name:GALLAZART PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:254-677-6549
Mailing Address - Street 1:7 PAWNEE LN
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-6627
Mailing Address - Country:US
Mailing Address - Phone:254-383-5849
Mailing Address - Fax:
Practice Address - Street 1:3513 SW H K DODGEN LOOP STE 200
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-8003
Practice Address - Country:US
Practice Address - Phone:254-677-6549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty