Provider Demographics
NPI:1437025251
Name:GALLAGHER, D RENAI (DPT)
Entity type:Individual
Prefix:DR
First Name:D
Middle Name:RENAI
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 SAN PEDRO DR NE STE 109
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4133
Mailing Address - Country:US
Mailing Address - Phone:505-314-4018
Mailing Address - Fax:505-214-5189
Practice Address - Street 1:2201 SAN PEDRO DR NE STE 109
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4133
Practice Address - Country:US
Practice Address - Phone:505-314-4018
Practice Address - Fax:505-214-5189
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist