Organization
GALLUS DETOX DALLAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK JOHN GALLUS M.D. (PRESIDENT)
(928) 227-2300
Entity
Organization
Contact information
Practice address
26791 US HIGHWAY 380 E, AUBREY, TX 76227-7654
(281) 277-0911
Mailing address
134 S GRANITE ST, PRESCOTT, AZ 86303-4710
(928) 227-2300
(928) 445-1416
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
12/03/2012
Last updated
12/11/2012
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