Provider Demographics
NPI:1629333786
Name:GALVAN, HERVEY (MPAS, PA-C)
Entity Type:Individual
Prefix:MR
First Name:HERVEY
Middle Name:
Last Name:GALVAN
Suffix:
Gender:M
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W EDINBURG HWY 107
Mailing Address - Street 2:
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78543
Mailing Address - Country:US
Mailing Address - Phone:956-262-9804
Mailing Address - Fax:956-262-9233
Practice Address - Street 1:200 W.EDINBURG HWY 107
Practice Address - Street 2:
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543-0000
Practice Address - Country:US
Practice Address - Phone:956-262-9804
Practice Address - Fax:956-262-9233
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04302363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical