Provider Demographics
NPI:1467593301
Name:CALLARMAN-REDDEN, SONJA RE (DC)
Entity Type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:RE
Last Name:CALLARMAN-REDDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3922
Mailing Address - Country:US
Mailing Address - Phone:281-812-4325
Mailing Address - Fax:281-446-4324
Practice Address - Street 1:36 WILSON RD
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3922
Practice Address - Country:US
Practice Address - Phone:281-812-4325
Practice Address - Fax:281-446-4324
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC9001111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606648OtherBCBS OF TX
TX00460YMedicare ID - Type UnspecifiedMEDICARE GROUP #
TX8D3466Medicare ID - Type UnspecifiedMEDICARE IDDENTIFICATION