Provider Demographics
NPI:1114792041
Name:GALARZA HERNANDEZ, ANGEL XAVIER (MS)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:XAVIER
Last Name:GALARZA HERNANDEZ
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4973
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4973
Mailing Address - Country:US
Mailing Address - Phone:939-339-3441
Mailing Address - Fax:
Practice Address - Street 1:BO. SALTOS II SEC. ROSADO CARR 445 KM 6 INT.
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:939-339-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7158103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist