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NPI Code Detail

MEDICARE: DR. LUIS GALVAN DDS

MEDICARE:  DR. LUIS  GALVAN  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry25595TX

General Provider Information

NPI Number : 1790096006
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUIS GALVAN DDS
Provider Business Mailing Address
First Line : 16918 BASIN OAK
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-6214
Country : US
Telephone Number : 210-632-2631
Fax Number :
Provider Business Practice Location Address
First Line : 9590 MARBACH RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78245-1825
Country : US
Telephone Number : 210-673-9051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2010
Last Update Date : 07/01/2010

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Directions to “ DR. LUIS GALVAN DDS” Practice Location

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