Provider Demographics
NPI:1164659397
Name:SALLEE, CALEB R (MD)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:R
Last Name:SALLEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1307
Mailing Address - Country:US
Mailing Address - Phone:806-799-7928
Mailing Address - Fax:806-788-8500
Practice Address - Street 1:3509 22ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1307
Practice Address - Country:US
Practice Address - Phone:806-799-7928
Practice Address - Fax:806-788-8500
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ3433208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ3433OtherTEXAS STATE BOARD OF MEDICAL EXAMINERS