Stacy Martyn Gallo, P.A. -C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1380 Pantheon Way
Suite 310
San Antonio, TX 78232-2288

Phone

(210) 404-9696

Fax

(210) 404-9466

NPI assigned

Aug 5, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1023397288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 BLUFFCOURT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782161907",
            "telephone_number": "210-378-5555",
            "fax_number": "210-378-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 PANTHEON WAY",
            "address_2": "SUITE 310",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322288",
            "telephone_number": "210-404-9696",
            "fax_number": "210-404-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "STACY",
        "middle_name": "MARTYN",
        "credential": "P.A. -C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-05",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth D Gallinger, O.D.
• Andrew Christopher Gallo, D.O.
• Daizha Gallo, PA
• Lisa Gallo
• Paree Lavonne Gallo, PA
• Debra E Gallop, FNP
• Edlyne Marie Gallos, RN, PCCN
• Kimberly Galloway
• Samantha Nicol Galloway, LPC
• Gallus Detox San Antonio, PLLC

• Medical Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.