Healthcare Provider Details

I. General information

NPI: 1124147913
Provider Name (Legal Business Name): WALTER A. DEL GALLO, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14317 NW BLVD SUITE A
CRP CHRISTI TX
78410-5536
US

IV. Provider business mailing address

14317 NW BLVD SUITE A
CRP CHRISTI TX
78410-5536
US

V. Phone/Fax

Practice location:
  • Phone: 361-241-0324
  • Fax: 361-387-4153
Mailing address:
  • Phone: 361-241-0324
  • Fax: 361-387-4153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberK0710
License Number StateTX

VIII. Authorized Official

Name: WALTER A DEL GALLO
Title or Position: OWNER
Credential: M.D.
Phone: 361-241-0324