Provider Demographics
NPI:1477589182
Name:GALAZ, ALFRED (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:
Last Name:GALAZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 SOUTH ADAMS AVENUE
Mailing Address - Street 2:
Mailing Address - City:MCGREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657-2352
Mailing Address - Country:US
Mailing Address - Phone:254-931-1410
Mailing Address - Fax:866-792-6239
Practice Address - Street 1:705 SOUTH ADAMS AVENUE
Practice Address - Street 2:
Practice Address - City:MCGREGOR
Practice Address - State:TX
Practice Address - Zip Code:76657-2352
Practice Address - Country:US
Practice Address - Phone:254-931-1410
Practice Address - Fax:866-792-6239
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31008103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F5902OtherMEDICARE
TX040399003Medicaid
TX87430AOtherBCBS
TX8F5902OtherMEDICARE