Provider Demographics
NPI:1427538859
Name:GALVAN-GARCIA, MARILIZA (LVN)
Entity Type:Individual
Prefix:
First Name:MARILIZA
Middle Name:
Last Name:GALVAN-GARCIA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 E AVENUE C
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-3918
Mailing Address - Country:US
Mailing Address - Phone:361-228-5559
Mailing Address - Fax:
Practice Address - Street 1:636 E AVENUE C
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-3918
Practice Address - Country:US
Practice Address - Phone:361-228-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310594164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse