1093980385 NPI number — GALLI FAMILY CHIROPRACTIC PA

Table of content: MISS KRISTI NOELLE LEWIS (NPI 1144957929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093980385 NPI number — GALLI FAMILY CHIROPRACTIC PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GALLI FAMILY CHIROPRACTIC PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093980385
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
109 FALLS CT
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
BOERNE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78006-2977
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-249-7858
Provider Business Mailing Address Fax Number:
830-249-6850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 FALLS CT
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
BOERNE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78006-2977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-249-7858
Provider Business Practice Location Address Fax Number:
830-249-6850
Provider Enumeration Date:
04/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GALLI
Authorized Official First Name:
CARLO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
830-249-7858

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  8686 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0090JK . This is a "BLUE CROSS AND BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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