Provider Demographics
NPI:1538629001
Name:GERALD J GALVIN CONVERSE CHIROPRACTIC
Entity type:Organization
Organization Name:GERALD J GALVIN CONVERSE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-658-6000
Mailing Address - Street 1:8014 KITTY HAWK
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2424
Mailing Address - Country:US
Mailing Address - Phone:210-658-6000
Mailing Address - Fax:210-658-6843
Practice Address - Street 1:8014 KITTY HAWK
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2424
Practice Address - Country:US
Practice Address - Phone:210-658-6000
Practice Address - Fax:210-658-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty