Individual provider Active NPI

Edidiong Galles, P.A.

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1275803082
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3500 Gaston Ave
Dallas, TX 75246-2017
Phone
(214) 820-0111
NPI assigned
Jan 10, 2012
Last updated
Jan 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2017

Mailing address

4055 Frankford Rd Apt 1324
Dallas, TX 75287-6620
Phone (507) 351-8616

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

Practice roles

OrganizationSpecialtyStatusNew patients
McKinney Emergency Physicians PLLC Past Accepting new patients
Dallas Anesthesiology Associates, PA Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Texas Em-I Medical Services, P.a. Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1275803082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 FRANKFORD RD APT 1324",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876620",
            "telephone_number": "507-351-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462017",
            "telephone_number": "214-820-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLES",
        "first_name": "EDIDIONG",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "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 Jan 10, 2012; 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.