Provider Demographics
NPI:1538239868
Name:GALLMAN, JAMES S (RPH, DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:GALLMAN
Suffix:
Gender:M
Credentials:RPH, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7753
Mailing Address - Country:US
Mailing Address - Phone:972-867-3577
Mailing Address - Fax:
Practice Address - Street 1:3705 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7753
Practice Address - Country:US
Practice Address - Phone:972-867-3577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213371835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX320213Medicaid
TX320213Medicaid