MEDICARE: AJAY GAALLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	J4134	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8DD946	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1104837772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AJAY GAALLA MD

Provider Business Mailing Address
First Line	:	2104 PATTERSON DR
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-5639
Country	:	US
Telephone Number	:	361-580-2200
Fax Number	:	361-580-2201

Provider Business Practice Location Address
First Line	:	2104 PATTERSON DR
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-5639
Country	:	US
Telephone Number	:	361-580-2200
Fax Number	:	361-580-2201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	06/01/2026

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Directions to “ AJAY GAALLA MD” Practice Location

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