Basic Information
Provider Information
NPI: 1265140867
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALANG
FirstName: JOMA
MiddleName: GUERRERO
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 N 23RD ST
Address2:  
City: MCALLEN
State: TX
PostalCode: 785016127
CountryCode: US
TelephoneNumber: 9566874559
FaxNumber: 9566181342
Practice Location
Address1: 2409 VETERANS BLVD STE 5
Address2:  
City: DEL RIO
State: TX
PostalCode: 788403127
CountryCode: US
TelephoneNumber: 8304886265
FaxNumber: 8304886269
Other Information
ProviderEnumerationDate: 11/11/2022
LastUpdateDate: 11/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1319837TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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