Provider Demographics
NPI:1164198370
Name:CALDERON, ABILOU (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABILOU
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:IDALOU
Mailing Address - State:TX
Mailing Address - Zip Code:79329-9018
Mailing Address - Country:US
Mailing Address - Phone:806-778-8721
Mailing Address - Fax:
Practice Address - Street 1:140 E PANHANDLE ST
Practice Address - Street 2:
Practice Address - City:SLATON
Practice Address - State:TX
Practice Address - Zip Code:79364-4238
Practice Address - Country:US
Practice Address - Phone:806-828-6591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist