MEDICARE: ROBERT GALLEGOS MA, LPC

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	101YM0800X	Mental Health Counselor	71501	TX
2	101YP2500X	Professional Counselor	71501	TX

General Provider Information

NPI Number	:	1366816803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT GALLEGOS MA, LPC

Provider Business Mailing Address
First Line	:	3301 MAGELLAN CT
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-2135
Country	:	US
Telephone Number	:	512-287-9864
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 FM 685 STE 450
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-7095
Country	:	US
Telephone Number	:	737-252-3570
Fax Number	:

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

Provider Enumeration Date	:	11/20/2015
Last Update Date	:	01/09/2024

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