Provider Demographics
NPI:1184712556
Name:GALVAN, ALICIA GREGORIA (DDS, FAAHD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:GREGORIA
Last Name:GALVAN
Suffix:
Gender:F
Credentials:DDS, FAAHD
Other - Prefix:MS
Other - First Name:ALICIA
Other - Middle Name:GREGORIA
Other - Last Name:GALVAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:7434 LOUIS PASTEUR DR
Mailing Address - Street 2:STE. 234
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4538
Mailing Address - Country:US
Mailing Address - Phone:210-617-4446
Mailing Address - Fax:210-617-5572
Practice Address - Street 1:7434 LOUIS PASTEUR DR
Practice Address - Street 2:STE. 234
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4538
Practice Address - Country:US
Practice Address - Phone:210-617-4446
Practice Address - Fax:210-617-5572
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21243122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist