Provider Demographics
NPI:1184023822
Name:INCALCATERRA MHT LLC
Entity Type:Organization
Organization Name:INCALCATERRA MHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:INCALCATERRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-335-5950
Mailing Address - Street 1:1515 HERITAGE DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3379
Mailing Address - Country:US
Mailing Address - Phone:972-616-4702
Mailing Address - Fax:
Practice Address - Street 1:1322 SPACE PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3400
Practice Address - Country:US
Practice Address - Phone:281-335-5950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5795207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty