Provider Demographics
NPI:1437338332
Name:GALUSTYAN, SVETLANA
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:GALUSTYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 BIRDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-2204
Mailing Address - Country:US
Mailing Address - Phone:832-372-0972
Mailing Address - Fax:832-778-8247
Practice Address - Street 1:5406 BIRDWOOD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-2204
Practice Address - Country:US
Practice Address - Phone:832-372-0972
Practice Address - Fax:832-778-8247
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No172V00000XOther Service ProvidersCommunity Health Worker