Organization
AMBULATORY FOOT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNONO GALLENTINE DPM (PRESIDENT)
(972) 230-1307
Entity
Organization
Contact information
Practice address
2700 W PLEASANT RUN RD, 360, LANCASTER, TX 75146-1079
(972) 230-1307
Mailing address
2700 W PLEASANT RUN RD, 360, LANCASTER, TX 75146-1079
(972) 230-1307
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
1513
TX
Other
Enumeration date
12/13/2006
Last updated
08/22/2020
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