Provider Demographics
NPI:1265753222
Name:MCGALIN, VIRGINIA HEATHMAN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:HEATHMAN
Last Name:MCGALIN
Suffix:
Gender:F
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 1:1050 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4739
Mailing Address - Country:US
Mailing Address - Phone:409-832-2306
Mailing Address - Fax:409-832-8199
Practice Address - Street 1:1050 S 11TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4739
Practice Address - Country:US
Practice Address - Phone:409-832-2306
Practice Address - Fax:409-832-8199
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX595065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily