Provider Demographics
NPI:1316016462
Name:CALDERON, LUIS E
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:E
Last Name:CALDERON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9004 FOREST CROSSING DR SUITE F
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381
Mailing Address - Country:US
Mailing Address - Phone:281-363-0642
Mailing Address - Fax:281-364-7947
Practice Address - Street 1:9004 FOREST CROSSING DR SUITE F
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381
Practice Address - Country:US
Practice Address - Phone:281-363-0642
Practice Address - Fax:281-364-7947
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX132421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX849287OtherUNITED CONCORDIA INC
TXD13242OtherBC BS INS
TX6524OtherDELTA DENTAL INC
TXB1324201OtherCHIPS GOVERNMENT CHILDREN