Provider Demographics
NPI:1013489079
Name:GALAN, MANUEL RENE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:RENE
Last Name:GALAN
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 N INTERSTATE 35
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7220
Mailing Address - Country:US
Mailing Address - Phone:512-648-6188
Mailing Address - Fax:
Practice Address - Street 1:1509 N INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7220
Practice Address - Country:US
Practice Address - Phone:512-648-6188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX140087363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily