Provider Demographics
NPI:1639126865
Name:CALDERON-NADAL, MAGALIS (PHD)
Entity Type:Individual
Prefix:
First Name:MAGALIS
Middle Name:
Last Name:CALDERON-NADAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 S 25TH ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8514
Mailing Address - Country:US
Mailing Address - Phone:956-536-0996
Mailing Address - Fax:956-423-3266
Practice Address - Street 1:1907 LUBBOCK ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8206
Practice Address - Country:US
Practice Address - Phone:956-536-0996
Practice Address - Fax:956-423-3266
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32292103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical