Provider Demographics
NPI:1437221975
Name:GALATAS, MARY VIRGINIA (PT)
Entity type:Individual
Prefix:MISS
First Name:MARY
Middle Name:VIRGINIA
Last Name:GALATAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4561
Mailing Address - Country:US
Mailing Address - Phone:972-506-8531
Mailing Address - Fax:
Practice Address - Street 1:9400 N MACARTHUR BLVD # 124-416
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4705
Practice Address - Country:US
Practice Address - Phone:972-506-8531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1095016225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist