MEDICARE: BRANDON GALLOWAY PT, DPT

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	225100000X	Physical Therapist		TX
2	225100000X	Physical Therapist	1339219	TX

General Provider Information

NPI Number	:	1730786906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON GALLOWAY PT, DPT

Provider Business Mailing Address
First Line	:	3301 SUNDOWN BLVD
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-8032
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 SUNDOWN BLVD
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-8032
Country	:	US
Telephone Number	:	940-387-3700
Fax Number	:

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

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	10/09/2020

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Directions to “ BRANDON GALLOWAY PT, DPT” Practice Location

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