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General NPI Number Information
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NPI Number | 1659604619
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Entity Type | Individual
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Provider Name | JUAN GALVAN P.A.C.
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Gender | Male
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 4770 N EXPRESSWAY SUITE 204
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4165
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Country | US
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Telephone | 956-350-8380
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Fax | 956-350-8371
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Provider Business Mailing Address
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Address Line | 4770 N EXPRESSWAY SUITE 204
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4165
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Country | US
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Telephone | 956-350-8380
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Fax | 956-350-8371
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06353
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License Number State | TX
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