Individual provider Active NPI

Matthew Reyes Galan

  • Clinical Medical Laboratory
  • Midland, TX
National Provider Identifier
1174896203
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
208 S Marienfeld St
Suite 128
Midland, TX 79701-5113
Phone
(432) 934-9674
Fax
(432) 687-3972
NPI assigned
Feb 21, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

208 S Marienfeld St
Suite 128
Midland, TX 79701-5113

Mailing address

208 S Marienfeld St
Suite 128
Midland, TX 79701-5113
Phone (432) 934-9674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1174896203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S MARIENFELD ST",
            "address_2": "SUITE 128",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015113",
            "telephone_number": "432-934-9674",
            "fax_number": "432-687-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S MARIENFELD ST",
            "address_2": "SUITE 128",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015113",
            "telephone_number": "432-934-9674",
            "fax_number": "432-687-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALAN",
        "first_name": "MATTHEW",
        "middle_name": "REYES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.