Provider Demographics
NPI:1669580924
Name:GALUTIA, ROBERT C (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:GALUTIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:WHEELER
Mailing Address - State:TX
Mailing Address - Zip Code:79096
Mailing Address - Country:US
Mailing Address - Phone:806-826-3581
Mailing Address - Fax:806-826-5279
Practice Address - Street 1:309 E 9TH
Practice Address - Street 2:
Practice Address - City:WHEELER
Practice Address - State:TX
Practice Address - Zip Code:79096
Practice Address - Country:US
Practice Address - Phone:806-826-3581
Practice Address - Fax:806-826-5279
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7935207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00801156OtherRAILROAD MEDICARE
TX089832204Medicaid
TX8AJ218OtherBCBS
TXP00801156OtherRAILROAD MEDICARE
TX8F22373Medicare PIN