Provider Demographics
NPI:1154020097
Name:GALVAN, CHRISTIAN ISAAC (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ISAAC
Last Name:GALVAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 CORNERSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8327
Mailing Address - Country:US
Mailing Address - Phone:956-686-5511
Mailing Address - Fax:
Practice Address - Street 1:2702 CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8327
Practice Address - Country:US
Practice Address - Phone:956-686-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX404241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice