Provider Demographics
NPI:1992080170
Name:GALLAGHER, KATRINA NICOLE (DC)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:NICOLE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:NICOLE
Other - Last Name:STEHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSACN
Mailing Address - Street 1:1518 LEGACY DR STE 280
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6042
Mailing Address - Country:US
Mailing Address - Phone:214-775-9953
Mailing Address - Fax:214-775-9953
Practice Address - Street 1:1518 LEGACY DR STE 280
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6042
Practice Address - Country:US
Practice Address - Phone:214-775-9953
Practice Address - Fax:214-775-9953
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
TX13955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No133N00000XDietary & Nutritional Service ProvidersNutritionist