Healthcare Provider Details

I. General information

NPI: 1316855778
Provider Name (Legal Business Name): GALIA BALL-MONTGOMERY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3312 MEREDITH AVE
OMAHA NE
68111-2338
US

IV. Provider business mailing address

3312 MEREDITH AVE
OMAHA NE
68111-2338
US

V. Phone/Fax

Practice location:
  • Phone: 402-706-1883
  • Fax:
Mailing address:
  • Phone: 402-706-1883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License Number105722
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: