Andrew Gallegos
Individual provider Active NPI Speech-Language Assistant · Ruidoso, NM
NPI 1588085484 · NPPES record last updated Dec 18, 2013
Key facts
- NPI
- 1588085484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Assistant 2355S0801X
- License
- 5402 (NM)
- Practice address
- 237 Service Rd
Ruidoso, NM 88345-6063 - Phone
- (575) 257-2368
- Fax
- (575) 257-2141
- NPI assigned
- Dec 18, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5402 | NM | MD | Speech-Language Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 5402 | NM | Yes |
Addresses
Primary practice location
237 Service Rd
Ruidoso, NM 88345-6063
Mailing address
237 Service Rd
Ruidoso, NM 88345-6063
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 850441031 | Medicaid | NM |
Other providers in Ruidoso, NM
- Charlene Frederick
- Frontier Medical Equipment, Inc.
- Jerri Fudge
- Alice C. Fuller
- Alyssa Gallegos
- Suquala Marie Gant
- Angelie Amelia Garcia
- Gary Garland
- Sandra S Gehrke-Olafson
- Karen Ginsberg
All providers in Ruidoso, NM · Speech-Language Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.