Provider Demographics
NPI:1598088411
Name:CALLISTUS ANYAMA
Entity Type:Organization
Organization Name:CALLISTUS ANYAMA
Other - Org Name:ST. CAL HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CALLISTUS
Authorized Official - Middle Name:ODII
Authorized Official - Last Name:ANYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-969-3299
Mailing Address - Street 1:2135 WAR ADMIRAL DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6351
Mailing Address - Country:US
Mailing Address - Phone:832-969-3299
Mailing Address - Fax:
Practice Address - Street 1:2135 WAR ADMIRAL DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6351
Practice Address - Country:US
Practice Address - Phone:832-969-3299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care