Provider Demographics
NPI:1750904231
Name:GALLEGOS, ANTHONY JAMES (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JAMES
Last Name:GALLEGOS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9179 GRISSOM RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2810
Mailing Address - Country:US
Mailing Address - Phone:210-680-8081
Mailing Address - Fax:210-680-3179
Practice Address - Street 1:9179 GRISSOM RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2810
Practice Address - Country:US
Practice Address - Phone:210-680-8081
Practice Address - Fax:210-680-3179
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU5102207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine