Provider Demographics
NPI:1093073074
Name:FARIAS, EDUARDO GALVAN (CSFA)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:GALVAN
Last Name:FARIAS
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6951 RAINTREE GRV
Mailing Address - Street 2:LOT 2
Mailing Address - City:ELMENDORF
Mailing Address - State:TX
Mailing Address - Zip Code:78112-7900
Mailing Address - Country:US
Mailing Address - Phone:210-787-9552
Mailing Address - Fax:210-635-9551
Practice Address - Street 1:6951 RAINTREE GRV
Practice Address - Street 2:LOT 2
Practice Address - City:ELMENDORF
Practice Address - State:TX
Practice Address - Zip Code:78112-7900
Practice Address - Country:US
Practice Address - Phone:210-787-9552
Practice Address - Fax:210-635-9279
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2017-02-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant