Provider Demographics
NPI:1063042778
Name:GALAN, RACHEL B
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:B
Last Name:GALAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-2395
Mailing Address - Country:US
Mailing Address - Phone:936-615-1802
Mailing Address - Fax:
Practice Address - Street 1:4215 RED OAK DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-2395
Practice Address - Country:US
Practice Address - Phone:936-615-1802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider