Individual provider Active NPI

Holly Marie Gallegos, P.A.

  • Medical Physician Assistant
  • Dallas, TX
National Provider Identifier
1164466595
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA02027 Issued in TX
Practice address
12221 Merit Dr
Ste 1610
Dallas, TX 75251-2202
Phone
(214) 217-1911
Fax
(214) 217-1912
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA02027 TX Primary

Addresses

Primary practice location

12221 Merit Dr
Ste 1610
Dallas, TX 75251-2202

Mailing address

12221 Merit Dr
Ste 1610
Dallas, TX 75251-2202
Phone (214) 217-1911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA02027TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Emergency Rooms Services, PA Past Accepting new patients
Reclaim Physicians Medical Group Inc Past Accepting new patients
Paul Phillips III, M.D., P.a. Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Medical Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1164466595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 MERIT DR",
            "address_2": "STE 1610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512202",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 MERIT DR",
            "address_2": "STE 1610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512202",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.