| Organization Name: | GALLUS DETOX DALLAS LLC |
| NPI Number: | 1659616647 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICK JOHN GALLUS (PRESIDENT) |
| Mailing Address: | 26791 Us Highway 380 E Aubrey |
| State: | TX US |
| Postal Code: | 762277654 |
| Phone Number: | 2812770911 |
| Fax Number: | |
| NPI Enumeration Date: | 12/03/2012 |
| NPI Last Update Date: | 12/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |