MEDICARE: MAIGRE E GALLO GONZALEZ NP

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	363L00000X	Nurse Practitioner	1135131	TX

General Provider Information

NPI Number	:	1922963677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAIGRE E GALLO GONZALEZ NP

Provider Business Mailing Address
First Line	:	7323 CRAGMONT BRIDGE DR
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-1720
Country	:	US
Telephone Number	:	346-279-7299
Fax Number	:

Provider Business Practice Location Address
First Line	:	7323 CRAGMONT BRIDGE DR
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-1720
Country	:	US
Telephone Number	:	346-279-7299
Fax Number	:

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/17/2025

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