Healthcare Provider Details

I. General information

NPI: 1780004994
Provider Name (Legal Business Name): JAMES B GALLOWAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2014
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 HARRY HINES BOULEVARD
DALLAS TX
75235
US

IV. Provider business mailing address

P.O. BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-3597
  • Fax: 214-645-6757
Mailing address:
  • Phone: 214-645-3597
  • Fax: 214-645-6757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR4549
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberR4549
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: