Healthcare Provider Details

I. General information

NPI: 1881155679
Provider Name (Legal Business Name): ELKIN D GALVIS-CARVAJAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 06/09/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18951 W MEMORIAL DR
HUMBLE TX
77338
US

IV. Provider business mailing address

1101 FM 109
BRENHAM TX
77833-7030
US

V. Phone/Fax

Practice location:
  • Phone: 281-540-7700
  • Fax:
Mailing address:
  • Phone: 979-270-1647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberT1941
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: