Provider Demographics
NPI:1619136918
Name:CABALLERO, JOSHUA D (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:CABALLERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-5586
Mailing Address - Country:US
Mailing Address - Phone:979-492-9450
Mailing Address - Fax:
Practice Address - Street 1:2401 SOUTH 31ST STREET
Practice Address - Street 2:DEPT OF EMERGENCY MEDICINE
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501
Practice Address - Country:US
Practice Address - Phone:979-492-9450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38635183500000X
TXN4317207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No183500000XPharmacy Service ProvidersPharmacist