Provider Demographics
NPI:1427570910
Name:CALDWELL, JAMES ALAN I
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:CALDWELL
Suffix:I
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 1:2615 FRITZ ST
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-2481
Mailing Address - Country:US
Mailing Address - Phone:469-633-6589
Mailing Address - Fax:469-633-6581
Practice Address - Street 1:1015 SAM RAYBURN TOLLWAY
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5620
Practice Address - Country:US
Practice Address - Phone:972-359-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional