Provider Demographics
NPI:1639372576
Name:GALVAN, JUAN C (DC)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:C
Last Name:GALVAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 503
Mailing Address - Street 2:
Mailing Address - City:GALENA PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77547-0503
Mailing Address - Country:US
Mailing Address - Phone:713-455-4344
Mailing Address - Fax:713-455-4247
Practice Address - Street 1:1202 HOLLAND AVE.
Practice Address - Street 2:
Practice Address - City:JACINTO CITY
Practice Address - State:TX
Practice Address - Zip Code:77029-2202
Practice Address - Country:US
Practice Address - Phone:713-455-4344
Practice Address - Fax:713-455-4247
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor