Individual
JEREMY SCOTT GALLUPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
1101 S MAIN ST, STE. 1600, FORT WORTH, TX 76104-4802
(817) 321-4936
(817) 850-8511
Mailing address
1101 S MAIN ST, STE. 1600, FORT WORTH, TX 76104-4802
(817) 321-4936
(817) 850-8511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
705518
TX
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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