Provider Demographics
NPI:1174896203
Name:GALAN, MATTHEW REYES
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:REYES
Last Name:GALAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:208 S MARIENFELD ST
Mailing Address - Street 2:SUITE 128
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5113
Mailing Address - Country:US
Mailing Address - Phone:432-934-9674
Mailing Address - Fax:432-687-3972
Practice Address - Street 1:208 S MARIENFELD ST
Practice Address - Street 2:SUITE 128
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5113
Practice Address - Country:US
Practice Address - Phone:432-934-9674
Practice Address - Fax:432-687-3972
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory