Phyllis Gallegos Santillan, MS, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Jbsa-Lackland Afb, TX
NPI 1629032867 · NPPES record last updated Oct 9, 2025
Key facts
- NPI
- 1629032867
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 102925 (TX)
- Practice address
- 1100 Wilford Hall Loop
BLDG. 4554
Jbsa-Lackland Afb, TX 78236-9908 - Phone
- (210) 292-5420
- Fax
- (210) 292-4527
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- 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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102925 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 102925 | TX | Yes |
Addresses
Primary practice location
1100 Wilford Hall Loop
BLDG. 4554
Jbsa-Lackland Afb, TX 78236-9908
Mailing address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-5420
Other practice location 1
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 539-9582
Other providers in Jbsa-Lackland Afb, TX
- Billy Cameron Denley
- Kenneth Fan
- Roger Louis Farney
- Michelle Lora Floyd
- Benjamin Jordan Franklin
- Blake Austin Harrell
- Jessica Rose White Harvey
- Shawn Knadler
- Seth Daniel Knapp
- Jason A Koskinen
All providers in Jbsa-Lackland Afb, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2025. 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.