=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023238011
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIK J GALIAN D.M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2007
-----------------------------------------------------
Last Update Date | 11/16/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 901 SOUTH MOPAC EXPRESSWAY BUILDING 5, SUITE 220
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-327-0461
-----------------------------------------------------
Fax | 512-327-0916
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 901 SOUTH MOPAC EXPRESSWAY BUILDING 5, SUITE 220
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-327-0461
-----------------------------------------------------
Fax | 512-327-0916
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223E0200X
-----------------------------------------------------
Taxonomy Name | Endodontics
-----------------------------------------------------
License Number | 19541
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------