Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 16187 | TX |
NPI | 1104046473 |
---|---|
Provider Name | Dr. Robert R Galvan |
First Address | Austin, TX 78746 |
Second Address | Austin, TX 78746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2007 |
Last Update Date | 21/10/2016 |