Provider Demographics
NPI:1013323450
Name:KULESZA-GALVEZ, THEODORA (MD)
Entity Type:Individual
Prefix:
First Name:THEODORA
Middle Name:
Last Name:KULESZA-GALVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 FREDRICKSBURG RD
Mailing Address - Street 2:STE 260 BLDG B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3763
Mailing Address - Country:US
Mailing Address - Phone:726-600-1775
Mailing Address - Fax:
Practice Address - Street 1:5414 FREDERICKSBURG RD STE 260
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3763
Practice Address - Country:US
Practice Address - Phone:210-452-2669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10059700207Q00000X
TXR7043207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine