Provider Demographics
NPI:1376729913
Name:GALVAN-RODRIGUEZ, JUAN GERARDO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:GERARDO
Last Name:GALVAN-RODRIGUEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 CUATRO VIENTOS DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-6946
Mailing Address - Country:US
Mailing Address - Phone:956-744-5137
Mailing Address - Fax:956-462-5003
Practice Address - Street 1:3511 CUATRO VIENTOS DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-6946
Practice Address - Country:US
Practice Address - Phone:210-863-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX529251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical