Provider Demographics
NPI:1699190678
Name:GALANG, MARI THERESE (RN, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:MARI
Middle Name:THERESE
Last Name:GALANG
Suffix:
Gender:F
Credentials:RN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 NORTH BLVD APT 5310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5126
Mailing Address - Country:US
Mailing Address - Phone:713-502-3745
Mailing Address - Fax:
Practice Address - Street 1:6560 FANNIN ST STE 1540
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2783
Practice Address - Country:US
Practice Address - Phone:713-502-3745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX749562363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care