Provider Demographics
NPI:1083197297
Name:LOVE, DINA CALLES
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:CALLES
Last Name:LOVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 HIDDEN RDG APT 3089
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3209
Mailing Address - Country:US
Mailing Address - Phone:214-636-5960
Mailing Address - Fax:
Practice Address - Street 1:1222 HIDDEN RDG APT 3089
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3209
Practice Address - Country:US
Practice Address - Phone:214-636-5960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216484164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse