Provider Demographics
NPI:1073951752
Name:MCCALL, ANGELA A (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:A
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 DRUMMOND ST
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-2404
Mailing Address - Country:US
Mailing Address - Phone:409-549-1740
Mailing Address - Fax:
Practice Address - Street 1:317 DRUMMOND ST
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-2404
Practice Address - Country:US
Practice Address - Phone:409-549-1740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT116577172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist