Provider Demographics
NPI:1316150592
Name:MARTHA M GALLIA OD PC
Entity type:Organization
Organization Name:MARTHA M GALLIA OD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GALLIA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-446-9333
Mailing Address - Street 1:9810 FM 1960 BYPASS RD W
Mailing Address - Street 2:STE 250
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3502
Mailing Address - Country:US
Mailing Address - Phone:281-446-9333
Mailing Address - Fax:281-446-6143
Practice Address - Street 1:9810 FM 1960 BYPASS RD W
Practice Address - Street 2:STE 250
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3502
Practice Address - Country:US
Practice Address - Phone:281-446-9333
Practice Address - Fax:281-446-6143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7433207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1508975301OtherPROVIDER NPI #
TX4187210001OtherDMEPOS
TXE41GOtherBCBS GROUP NUMBER
TX1740237973OtherPROVIDER NPI
TX1508975301OtherPROVIDER NPI #
TXE41GOtherBCBS GROUP NUMBER
TX1740237973OtherPROVIDER NPI