Individual provider Active NPI

Robert R Galvan, DDS

  • Endodontics
  • Austin, TX
National Provider Identifier
1104046473
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
16187 Issued in TX
Practice address
901 South Mopac Expressway
Building 5, Suite 220
Austin, TX 78746
Phone
(512) 327-0461
Fax
(512) 327-0916
NPI assigned
Apr 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 16187 TX Primary

Addresses

Primary practice location

901 South Mopac Expressway
Building 5, Suite 220
Austin, TX 78746

Mailing address

901 South Mopac Expressway,
BLDG 5, Suite 220
Austin, TX 78746
Phone (512) 327-0461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191108002160 TX Order and Referring Only - DentistPractitioner - Dentist 1850723073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16187TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Endodontics LLP Endodontics Past Accepting new patients
Michael B. Doughty Endodontics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1104046473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SOUTH MOPAC EXPRESSWAY,",
            "address_2": "BLDG 5, SUITE 220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78746",
            "telephone_number": "512-327-0461",
            "fax_number": "512-327-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SOUTH MOPAC EXPRESSWAY",
            "address_2": "BUILDING 5, SUITE 220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78746",
            "telephone_number": "512-327-0461",
            "fax_number": "512-327-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVAN",
        "first_name": "ROBERT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "16187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.