Provider Demographics
NPI:1518902626
Name:CALLE, CRISTO A (INTERNAL MEDICINE)
Entity Type:Individual
Prefix:DR
First Name:CRISTO
Middle Name:A
Last Name:CALLE
Suffix:
Gender:M
Credentials:INTERNAL MEDICINE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3118 CLARK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-5776
Mailing Address - Country:US
Mailing Address - Phone:210-533-7000
Mailing Address - Fax:210-533-3770
Practice Address - Street 1:3118 CLARK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-5776
Practice Address - Country:US
Practice Address - Phone:210-533-7000
Practice Address - Fax:210-533-3770
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA70HMedicare ID - Type Unspecified
TXC14090Medicare UPIN
TX00A70HMedicare PIN