Healthcare Provider Details

I. General information

NPI: 1801441365
Provider Name (Legal Business Name): HARMONI SUZANNE GALLEGOS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W TRINITY ST
GROESBECK TX
76642-1324
US

IV. Provider business mailing address

204 W TRINITY ST
GROESBECK TX
76642-1324
US

V. Phone/Fax

Practice location:
  • Phone: 254-729-3740
  • Fax: 254-729-8760
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1032687
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: