Provider Demographics
NPI:1962743237
Name:GALLAGHER, LAURA LYN (DO)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LYNN
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7777 FOREST LN STE C335
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2544
Mailing Address - Country:US
Mailing Address - Phone:972-325-1226
Mailing Address - Fax:214-872-9937
Practice Address - Street 1:7777 FOREST LN STE C335
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2544
Practice Address - Country:US
Practice Address - Phone:972-325-1226
Practice Address - Fax:214-872-9937
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018015584208600000X
390200000X
TXS3576208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty