Provider Demographics
NPI:1326593757
Name:GALVAN, DAYLON DEWAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAYLON
Middle Name:DEWAYNE
Last Name:GALVAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7838 HUEBNER RD
Mailing Address - Street 2:APT. 4105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3167
Mailing Address - Country:US
Mailing Address - Phone:409-718-5067
Mailing Address - Fax:
Practice Address - Street 1:1004 N TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4511
Practice Address - Country:US
Practice Address - Phone:956-467-1747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX322171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice