Healthcare Provider Details

I. General information

NPI: 1003105628
Provider Name (Legal Business Name): CARMEN GALEA NIEVES D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMEN GALEA D.D.S.

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 FT RICHARDSON AVE, BLDG 1001
GOODFELLOW AFB TX
76908
US

IV. Provider business mailing address

271 FT RICHARDSON AVE, BLDG 1001
GOODFELLOW AFB TX
76908
US

V. Phone/Fax

Practice location:
  • Phone: 325-654-3050
  • Fax:
Mailing address:
  • Phone: 325-654-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number60654
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN30019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: