Healthcare Provider Details

I. General information

NPI: 1932506193
Provider Name (Legal Business Name): GALLOWAY CHIROPRACTIC CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9410 FM 1960 RD W
HOUSTON TX
77070-6211
US

IV. Provider business mailing address

9410 FM 1960 RD W
HOUSTON TX
77070-6211
US

V. Phone/Fax

Practice location:
  • Phone: 281-890-4828
  • Fax: 281-890-7721
Mailing address:
  • Phone: 281-890-4828
  • Fax: 281-890-7721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2802
License Number StateTX

VIII. Authorized Official

Name: DR. ROBERT LEE GALLOWAY III
Title or Position: PRESIDENT
Credential: D.C.
Phone: 281-890-4828