Provider Demographics
NPI:1235703026
Name:CALVILLO, ALISA MICHELLE (PT)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:MICHELLE
Last Name:CALVILLO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8240 N MOPAC EXPY STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8869
Mailing Address - Country:US
Mailing Address - Phone:512-410-3754
Mailing Address - Fax:512-407-9010
Practice Address - Street 1:16040 PARK VALLEY DR STE 111
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-3596
Practice Address - Country:US
Practice Address - Phone:512-248-2200
Practice Address - Fax:512-248-1950
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-10-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist