Provider Demographics
NPI:1619974326
Name:GALVAN, DIANA R (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:R
Last Name:GALVAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 N NAVARRO ST STE 103
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3946
Mailing Address - Country:US
Mailing Address - Phone:361-575-9355
Mailing Address - Fax:361-485-9059
Practice Address - Street 1:2805 N NAVARRO ST STE 103
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3946
Practice Address - Country:US
Practice Address - Phone:361-575-9355
Practice Address - Fax:361-485-9059
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX522432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8E0272Medicare ID - Type Unspecified
TXP13681Medicare UPIN