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Individual

EDIDIONG GALLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
3500 GASTON AVE, DALLAS, TX 75246-2017
(214) 820-0111
Mailing address
4055 FRANKFORD RD APT 1324, DALLAS, TX 75287-6620
(507) 351-8616

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TX

Other

Enumeration date
01/10/2012
Last updated
01/10/2012
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