Provider Demographics
NPI:1235617853
Name:GOMEZ-GALVAN, VALERIZ (SLP)
Entity Type:Individual
Prefix:
First Name:VALERIZ
Middle Name:
Last Name:GOMEZ-GALVAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 E FM 495 STE B
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-4769
Mailing Address - Country:US
Mailing Address - Phone:956-283-5499
Mailing Address - Fax:
Practice Address - Street 1:516 E FM 495 STE B
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-4769
Practice Address - Country:US
Practice Address - Phone:956-283-5499
Practice Address - Fax:956-283-5310
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist