Individual
MR. ELIAS LOPEZ GALVAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1825 FORTVIEW RD, SUITE 109, AUSTIN, TX 78704-7657
(512) 892-5250
(512) 892-7183
Mailing address
3109 JONES RD, SUNSET VALLEY, TX 78745-1334
(512) 671-0726
(512) 892-7183
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1148279
TX
2251G0304X
Geriatric Physical Therapist
1148279
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
870T83
BCBS
TX
Enumeration date
11/06/2006
Last updated
11/14/2019
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