Provider Demographics
NPI:1912568288
Name:GALVAN, NINFA YARITZA (DDS)
Entity type:Individual
Prefix:DR
First Name:NINFA
Middle Name:YARITZA
Last Name:GALVAN
Suffix:
Gender:F
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:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-1209
Mailing Address - Country:US
Mailing Address - Phone:956-774-5262
Mailing Address - Fax:
Practice Address - Street 1:1515 PAPPAS ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-1705
Practice Address - Country:US
Practice Address - Phone:956-795-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice